Perry Dental, Ltd
Dentist, General Practice in Eyota, MN. Organization (NPI-2).
NPI number1417469198
StatusActive
Last updated in NPPESNov 2, 2017
Details
- NPI
- 1417469198
- Entity type
- Organization (NPI-2)
- Legal business name
- Perry Dental, Ltd
- Organization subpart
- Yes
- Enumeration date
- Nov 2, 2017
- Last updated
- Nov 2, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D12826 | MN | Yes |
Practice location
515 Jefferson Ave S.W.Eyota, MN 55934
Phone 507-585-5200 · Fax 507-585-5202
Mailing address
515 Jefferson Ave S.W.Eyota, MN 55934
Phone 507-585-5200 · Fax 507-585-5202
Authorized official
Joseph Thomas Line
Dentist
5075855200
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