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Organization
DIAMOND TRAIL DENTAL PC
Active
Organization
DIAMOND TRAIL DENTAL PC
Active
Other names
Diamond Trail Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC CHAD DEBOEF D.D.S. (PRESIDENT)
(641) 673-3008
Entity
Organization
Contact information
Practice address
301 S. 4TH ST., MONTEZUMA, IA 50171-1031
(641) 623-5100
Mailing address
107 HIGH AVE E, OSKALOOSA, IA 52577-2831
(641) 673-3008
(641) 672-8807
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/04/2013
Last updated
02/04/2013
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