NPI | 1902814650 |
---|---|
Doing Business As | PINES FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | CHRIS B LUNDELL President 563-557-8262 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IA 6304) |
Enumeration Date | 2006-08-04 |
Last Update Date | 2020-08-22 |