Provider Demographics
NPI:1730217654
Name:FAMILY DENTISTRY, LLP
Entity type:Organization
Organization Name:FAMILY DENTISTRY, LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:T
Authorized Official - Last Name:MARSHO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:641-236-6169
Mailing Address - Street 1:825 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-2153
Mailing Address - Country:US
Mailing Address - Phone:641-236-6169
Mailing Address - Fax:641-236-6041
Practice Address - Street 1:825 BROAD ST
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-2153
Practice Address - Country:US
Practice Address - Phone:641-236-6169
Practice Address - Fax:641-236-6041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty