| Cedar Dental | |
|
4201 1st Ave Se Cedar Rapids IA 52402-3144 | |
| (319) 899-1765 | |
| (319) 364-6529 |
| Full Name | Cedar Dental |
|---|---|
| Speciality | Dentist |
| Location | 4201 1st Ave Se, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Peter Joseph Ruggiero (CEO) |
| Authorized Official Contact | 3198991765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Dental 4201 1st Ave Se Cedar Rapids IA 52402-3144 Ph: (319) 899-1765 | Cedar Dental 4201 1st Ave Se Cedar Rapids IA 52402-3144 Ph: (319) 899-1765 |
| NPI Number | 1275108532 |
|---|---|
| Provider Enumeration Date | 05/20/2021 |
| Last Update Date | 05/20/2021 |
| Medicare PECOS PAC ID | 4688028038 |
|---|---|
| Medicare Enrollment ID | O20231004000184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275108532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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