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Organization

PERRY DENTAL, LTD

Active
Parent organization
PERRY DENTAL, LTD
Organization subpart
Yes

Provider details

NPI number
Legal business name
PERRY DENTAL, LTD
Authorized official
MR. JOSEPH THOMAS LINE D.D.S. (DENTIST)
(507) 585-5200
Entity
Organization

Contact information

Practice address
515 JEFFERSON AVE S.W., EYOTA, MN 55934
(507) 585-5200
(507) 585-5202
Mailing address
515 JEFFERSON AVE S.W., EYOTA, MN 55934
(507) 585-5200
(507) 585-5202

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12826
MN

Other

Enumeration date
11/02/2017
Last updated
11/02/2017
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