Organization
TOWN SQUARE DENTAL CARE, PC
Active
Other names
Town Square Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC CHAD DE BOEF D.D.S. (PRESIDENT)
(641) 673-3008
Entity
Organization
Contact information
Practice address
107 HIGH AVE E, OSKALOOSA, IA 52577-2831
(641) 673-3008
Mailing address
107 HIGH AVE E, OSKALOOSA, IA 52577-2831
(641) 673-3008
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
08216
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1291526
—
IA
Enumeration date
05/14/2008
Last updated
05/14/2008
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