| Klise Dentistry, Pllc | |
|
1008 W Pleasant St Pleasantville IA 50225-9546 | |
| (515) 848-3691 | |
| Not Available |
| Full Name | Klise Dentistry, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1008 W Pleasant St, Pleasantville, Iowa |
| Authorized Official Name and Position | Alec James Klise (OWNER) |
| Authorized Official Contact | 5158483691 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Klise Dentistry, Pllc 1008 W Pleasant St Pleasantville IA 50225-9546 Ph: (515) 848-3691 | Klise Dentistry, Pllc 1008 W Pleasant St Pleasantville IA 50225-9546 Ph: (515) 848-3691 |
| NPI Number | 1760934756 |
|---|---|
| Provider Enumeration Date | 10/26/2016 |
| Last Update Date | 10/26/2016 |
| Medicare PECOS PAC ID | 8527304278 |
|---|---|
| Medicare Enrollment ID | O20190116003629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760934756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Alec J Klise |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1871935536 PECOS PAC ID: 8921345737 Enrollment ID: I20190131002214 |
Stone Ridge Dental Plc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1008 W Pleasant Street, Pleasantville, IA 50225 Phone: 515-848-3691 Fax: 515-848-3692 |