| NPI | 1144617721 |
|---|---|
| Other Name | BLAIR RIDGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | AMY N WILKEN-HEYING Owner 319-396-3596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IA DDS-08160) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2015-04-21 |