Organization
C & O DENTAL ENTERPRISES PLC
Active
Parent organization
C & O DENTAL ENTERPRISES, PLC
Other names
Boelter & Gross
Organization subpart
Yes
Provider details
NPI number
Legal business name
C & O DENTAL ENTERPRISES, PLC
Authorized official
JOHN PAUL CLAY DDS (OWNER)
(515) 570-5695
Entity
Organization
Contact information
Practice address
410 N WESTERN ST, SANBORN, IA 51248-1109
(712) 930-5550
Mailing address
1905 N 15TH ST, FORT DODGE, IA 50501-7604
(515) 573-7601
(515) 576-3962
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193400000
—
IA
05
—
193400000X
—
IA
Enumeration date
12/03/2019
Last updated
12/03/2019
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