Prairie Trails Family Dental Llc is a health care provider in Corydon, IA. In this page you will find its mailing address, practice location, phone number, specialty etc.
|Practice Location||100 E South St, Corydon, IA 50060-1724, US|
|Practice Location Phone||641-872-2514|
|Practice Location Fax||641-872-1152|
|Legal Business Name||PRAIRIE TRAILS FAMILY DENTAL LLC|
|Enumeration Date ?||Dec 18, 2012|
|Last Update Date ?||Nov 18, 2013|
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
|Specialty||Provider Type||Specialization||License||License State|
An authorized official is an appointed official with the legal authority to make changes and/or updates to the Prairie Trails Family Dental Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).
|Authorized Official||Susan Henderson|
|Authorized Official Title/Position||DIR. ADMINISTRATIVE SERVICES|
|Authorized Official Phone Number||641-872-5341|