| C & O Dental Enterprises Plc | |
|
410 N Western St Sanborn IA 51248-1109 | |
| (712) 930-5550 | |
| Not Available |
| Full Name | C & O Dental Enterprises Plc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 410 N Western St, Sanborn, Iowa |
| Authorized Official Name and Position | John Paul Clay (OWNER) |
| Authorized Official Contact | 5155705695 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C & O Dental Enterprises Plc 1905 N 15th St Fort Dodge IA 50501-7604 Ph: (515) 573-7601 | C & O Dental Enterprises Plc 410 N Western St Sanborn IA 51248-1109 Ph: (712) 930-5550 |
| NPI Number | 1558908145 |
|---|---|
| Provider Enumeration Date | 12/03/2019 |
| Last Update Date | 12/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558908145 | NPI | - | NPPES |
| 193400000 | Medicaid | IA | |
| 193400000X | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Terry L Boelter Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 N Western St, Sanborn, IA 51248 Phone: 712-930-5550 Fax: 712-930-5575 |