| Mrb Enterprises Pc | |
|
133 E Mayne St Blue Grass IA 52726-9718 | |
| (563) 381-4830 | |
| Not Available |
| Full Name | Mrb Enterprises Pc |
|---|---|
| Speciality | Dentist |
| Location | 133 E Mayne St, Blue Grass, Iowa |
| Authorized Official Name and Position | Philip Robert Bayne (OWNER/PRESIDENT) |
| Authorized Official Contact | 5633814830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mrb Enterprises Pc 133 E Mayne St Blue Grass IA 52726-9718 Ph: (563) 381-4830 | Mrb Enterprises Pc 133 E Mayne St Blue Grass IA 52726-9718 Ph: (563) 381-4830 |
| NPI Number | 1013141373 |
|---|---|
| Provider Enumeration Date | 05/14/2009 |
| Last Update Date | 05/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013141373 | NPI | - | NPPES |
| 11501 | Other | IA | BLUE CROSS BLUE SHIELD |
| 1154355162 | Other | IA | TYPE I NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 7609 (Iowa) | Primary |