Organization
MAIN FAMILY DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNN RAYMNOD GRIEBAHN JR. DDS (PRESIDENT)
(563) 323-2571
Entity
Organization
Contact information
Practice address
1905 N MAIN ST, DAVENPORT, IA 52803-2908
(563) 323-2571
(563) 323-1069
Mailing address
1905 N MAIN ST, DAVENPORT, IA 52803-2908
(563) 323-2571
(563) 323-1069
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6943
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0431924
—
IA
Enumeration date
12/26/2006
Last updated
08/22/2020
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