| Des Moines Pediatric Dental Center | |
|
4949 Westown Pkwy Suite 150 West Des Moines IA 50266-6702 | |
| (515) 225-0066 | |
| (515) 226-0998 |
| Full Name | Des Moines Pediatric Dental Center |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4949 Westown Pkwy, West Des Moines, Iowa |
| Authorized Official Name and Position | Matthew Perry Kubovich (OWNER) |
| Authorized Official Contact | 5152250066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Des Moines Pediatric Dental Center 4949 Westown Pkwy Ste 150 West Des Moines IA 50266-6702 Ph: (515) 225-0066 | Des Moines Pediatric Dental Center 4949 Westown Pkwy Suite 150 West Des Moines IA 50266-6702 Ph: (515) 225-0066 |
| NPI Number | 1386811677 |
|---|---|
| Provider Enumeration Date | 05/15/2008 |
| Last Update Date | 11/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386811677 | NPI | - | NPPES |
| 1291575 | Medicaid | IA | |
| 1745344 | Other | IA | UNITED CONCORDIA |
| 35184 | Other | IA | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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