Provider First Line Business Practice Location Address:
1000 42ND STEET SOUTHEAST RAPIDS DENTAL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CEDAR RAPIDS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-249-6970
Provider Business Practice Location Address Fax Number:
319-249-6970
Provider Enumeration Date:
07/29/2009