Organization
VIDENTA, LLC
Active
Organization subpart
No
Provider details
NPI number
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
08/22/2023
Last updated
08/22/2023
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