| 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 |