Organization
FOTENE GENNATOS DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FOTENE GENNATOS (OWNER/PRESIDENT)
(406) 451-6174
Entity
Organization
Contact information
Practice address
415 W 5TH ST, STORM LAKE, IA 50588-1725
(712) 732-2277
Mailing address
3008 VALLEY DR, SIOUX CITY, IA 51104-4063
(406) 451-6174
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/25/2019
Last updated
02/12/2024
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