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Organization
FRIENDLY DENTAL
Active
Organization
FRIENDLY DENTAL
Active
Parent organization
FRIENDLY DENTAL PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRIENDLY DENTAL PC
Authorized official
MRS. JARI L JOHNSON (OFFICE MANAGER)
(507) 376-5525
Entity
Organization
Contact information
Practice address
611 3RD AVE, SIBLEY, IA 51249-1626
(712) 754-2288
(712) 754-4865
Mailing address
611 3RD AVE, SIBLEY, IA 51249-1626
(712) 754-2288
(712) 754-4865
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
07092
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316975568
INDIVIDUAL NPI JERRY L. JOHNSON, DDS
MN
01
—
1770672958
PRIMARY LOCATION NPI
MN
01
—
1922167410
INDIVIDUAL NPI KELLY PHILLIPS, DDS
MN
Enumeration date
09/02/2010
Last updated
09/02/2010
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