| NPI | 1699317685 | 
|---|---|
| Doing Business As | PLATINUM DENTAL CARE | 
| Entity Type | Organization | 
| Authorized Contact | JACOB WARNER Credentialing Manager 385-279-4334 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 122300000X Dentist | 
| Additional Taxonomies | 1223P0300X Dentist, Periodontics | 
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2019-10-11 | 
| Last Update Date | 2019-10-11 |