| NPI | 1407560535 |
|---|---|
| Other Name | DOCS DENTAL TINKER AFB |
| Doing Business As | DENTRUST DENTAL PA |
| Entity Type | Organization |
| Authorized Contact | AMANDA CLARK Director Of Credentialing 267-362-5938 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-01-12 |
| Last Update Date | 2023-01-12 |