NPI | 1265040877 |
---|---|
Doing Business As | IMBODEN FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | KAREN M IMBODEN Owner 870-633-4591 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2020-07-20 |
Last Update Date | 2020-08-11 |