| NPI | 1013748615 |
|---|---|
| Doing Business As | GLENDALE FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | BRANDON STAFFORD Owner 507-208-3987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2024-08-13 |