Diamond Trail Dental PC

NPI #1164761698 in Montezuma, Iowa

Provider Information

NPI Number: 1164761698
Entity Type: Organization
Organization Name: Diamond Trail Dental PC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Feb 4, 2013
Last Updated: Feb 4, 2013

Practice Location

Address: 301 S. 4TH ST.
City: Montezuma
State: Iowa
ZIP Code: 50171-1031
Phone: (641) 623-5100

Authorized Official

Name: MR. ERIC CHAD DEBOEF, D.D.S.
Title: PRESIDENT
Phone: (641) 673-3008

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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