Organization
ADVANCED FAMILY DENTISTRY LLC
Active
Parent organization
VIDENTA, LLC
Other names
Advanced Family Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
VIDENTA, LLC
Authorized official
MR. LUCAS BLAND (COO)
(515) 577-6367
Entity
Organization
Contact information
Practice address
907 N ANKENY BLVD, ANKENY, IA 50023-4002
(515) 964-1490
Mailing address
907 N ANKENY BLVD, ANKENY, IA 50023-4002
(515) 964-1490
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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