Organization
TERRY L BOELTER DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY L BOELTER D.D.S. (OWNER)
(712) 930-5550
Entity
Organization
Contact information
Practice address
410 N WESTERN ST, SANBORN, IA 51248-1109
(712) 930-5550
(712) 930-5575
Mailing address
410 N WESTERN ST, SANBORN, IA 51248-1109
(712) 930-5550
(712) 930-5575
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6554
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004648
—
IA
Enumeration date
03/06/2007
Last updated
08/22/2020
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