Provider First Line Business Practice Location Address:
LUSH DENTAL, PLC
Provider Second Line Business Practice Location Address:
2505 SE ENCOMPASS DR.
Provider Business Practice Location Address City Name:
WAUKEE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50263-8099
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-303-0909
Provider Business Practice Location Address Fax Number:
641-421-7622
Provider Enumeration Date:
08/03/2006