Provider Demographics
NPI:1396212759
Name:C & O DENTAL ENTERPRISES PLC
Entity Type:Organization
Organization Name:C & O DENTAL ENTERPRISES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PLC
Authorized Official - Phone:515-573-7601
Mailing Address - Street 1:1320 10TH AVE N
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-2704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:IA
Practice Address - Zip Code:50554-1425
Practice Address - Country:US
Practice Address - Phone:712-841-4930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty