| NPI | 1407006679 |
|---|---|
| Other Name | NOELRIDGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JEANNIE MARIE COLLINS Owner 319-393-6152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 7922) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 08567) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2008-09-24 |