Organization
JERSEY RIDGE DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L SAMUELSON (PARTNER)
(563) 359-9144
Entity
Organization
Contact information
Practice address
5105 JERSEY RIDGE ROAD, DAVENPORT, IA 52807-3134
(563) 359-9144
(563) 359-9146
Mailing address
5105 JERSEY RIDGE ROAD, DAVENPORT, IA 52807-3134
(563) 359-9144
(563) 359-9146
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/29/2006
Last updated
07/24/2008
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