Organization
COUNTRYSIDE DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE DUNCAN (OFFICE MANAGER)
(515) 224-1618
Entity
Organization
Contact information
Practice address
1903 EP TRUE PKWY # S301, WEST DES MOINES, IA 50265-7000
(515) 224-1618
Mailing address
1903 EP TRUE PKWY # S301, WEST DES MOINES, IA 50265-7000
(515) 224-1618
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/05/2010
Last updated
05/05/2010
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