NPI | 1053432047 |
---|---|
Doing Business As | THE DENTAL DEPOT |
Entity Type | Organization |
Authorized Contact | RICHARD F HETTINGER Owner 712-239-5812 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 6429) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 7590) |
Enumeration Date | 2007-04-03 |
Last Update Date | 2008-06-24 |