| NPI | 1699151993 |
|---|---|
| Doing Business As | GREAT LAKES DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | JANET LYNN BOYES Dentist 641-529-0291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 09115) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-10 |