NPI | 1275670747 |
---|---|
Doing Business As | FAMILY DENTAL CENTER |
Entity Type | Organization |
Authorized Contact | TERESA L PORTER Credentialing Manager 660-890-8156 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2007-01-31 |
Last Update Date | 2020-09-15 |