NPI | 1306612122 |
---|---|
Doing Business As | MOBILE DENTAL SERVICES 1 |
Entity Type | Organization |
Authorized Contact | CARRIE BLACK Provider Relations Manager 775-888-6610 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2023-12-01 |
Last Update Date | 2024-06-11 |