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322 Dental Science Bldg Iowa City IA 52242-1001 | |
| (319) 335-7440 | |
| (319) 335-7451 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 322 Dental Science Bldg, Iowa City, Iowa |
| Authorized Official Name and Position | Paulina Janczuk (ASSOCIATE DEAN FOR FINANCE AND ADMI) |
| Authorized Official Contact | 3194670735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
322 Dental Science Bldg Iowa City IA 52242-1001 Ph: (319) 335-7440 | 322 Dental Science Bldg Iowa City IA 52242-1001 Ph: (319) 335-7440 |
| NPI Number | 1609956234 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 12/18/2024 |
| Medicare PECOS PAC ID | 7618884230 |
|---|---|
| Medicare Enrollment ID | O20120523000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609956234 | NPI | - | NPPES |
| 0007567 | Medicaid | IA | |
| 855764 | Other | IA | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | (* (Not Available)) | Secondary |
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