Organization
MASON CITY ENDODONTICS LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARENA GELL (MANAGER)
(641) 530-2657
Entity
Organization
Contact information
Practice address
1530 S MONROE AVE, MASON CITY, IA 50401-5606
(641) 530-2657
Mailing address
266 TRILLIUM ST NW, CONCORD, NC 28027-7205
(704) 644-9444
(704) 787-8587
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205990355
PROVIDER INFORMATION
NC
Enumeration date
06/21/2019
Last updated
01/02/2020
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