NPI | 1457911091 |
---|---|
Doing Business As | UNIVERSITY DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | SHARON L LOSO Credentialing Specialist 563-582-1448 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist |
Enumeration Date | 2019-06-17 |
Last Update Date | 2019-07-29 |