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Organization

CORRIDOR ENDODONTICS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BEN JORGENSEN DDS (OWNER)
(319) 800-9077
Entity
Organization

Contact information

Practice address
550 POND VIEW DR, SUITE 2, NORTH LIBERTY, IA 52317-2507
(319) 459-1975
(319) 459-1977
Mailing address
550 POND VIEW DR, SUITE 2, NORTH LIBERTY, IA 52317-2507
(319) 459-1975
(319) 459-1977

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
09095
IA

Other

Enumeration date
07/02/2014
Last updated
07/02/2014
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