Provider First Line Business Practice Location Address:
6128 DOUGLAS AVE
Provider Second Line Business Practice Location Address:
DOUGLAS DENTAL PC
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-270-6809
Provider Business Practice Location Address Fax Number:
515-270-4959
Provider Enumeration Date:
05/20/2008