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Individual

DR. FOTENE GENNATOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S

Contact information

Practice address
415 W 5TH ST, STORM LAKE, IA 50588-1725
(712) 732-2277
Mailing address
415 W 5TH ST, STORM LAKE, IA 50588-1725
(712) 732-2277

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08276
IA
1223G0001X
General Practice Dentistry
08276
IA

Other

Enumeration date
12/02/2005
Last updated
02/12/2024
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