Organization
FAMILY FIRST DENTAL OF PRIMGHAR, P.C.
Active
Other names
Family 1st Dental of Lake City
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES S. SKOGLUND DDS (OWNER)
(402) 644-3177
Entity
Organization
Contact information
Practice address
1331 W MAIN ST, LAKE CITY, IA 51449-1585
(712) 464-3124
Mailing address
1331 W MAIN ST, LAKE CITY, IA 51449-1585
(712) 464-3124
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08163
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0265447
—
IA
05
—
10025042400
—
NE
01
—
55729
WELLMARK
IA
Enumeration date
07/18/2008
Last updated
01/07/2009
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