| NPI | 1407189517 |
|---|---|
| Doing Business As | THE DETNAL RANCH |
| Entity Type | Organization |
| Authorized Contact | MATT FREDERICK KERN President 888-336-8839 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2009-09-09 |