Mrb Enterprises Pc | |
133 E Mayne St Blue Grass IA 52726-9718 | |
(563) 381-4830 | |
Not Available |
Full Name | Mrb Enterprises Pc |
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Speciality | Dentist |
Location | 133 E Mayne St, Blue Grass, Iowa |
Authorized Official Name and Position | Philip Robert Bayne (OWNER/PRESIDENT) |
Authorized Official Contact | 5633814830 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mrb Enterprises Pc 133 E Mayne St Blue Grass IA 52726-9718 Ph: (563) 381-4830 | Mrb Enterprises Pc 133 E Mayne St Blue Grass IA 52726-9718 Ph: (563) 381-4830 |
NPI Number | 1013141373 |
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Provider Enumeration Date | 05/14/2009 |
Last Update Date | 05/14/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013141373 | NPI | - | NPPES |
11501 | Other | IA | BLUE CROSS BLUE SHIELD |
1154355162 | Other | IA | TYPE I NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 7609 (Iowa) | Primary |