| Paul R Black Dds Pc | |
|
2525 Kimberly Rd Ste 3 Bettendorf IA 52722-3538 | |
| (563) 359-8271 | |
| (563) 359-8272 |
| Full Name | Paul R Black Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 2525 Kimberly Rd Ste 3, Bettendorf, Iowa |
| Authorized Official Name and Position | Paul R Black (PRESIDENT) |
| Authorized Official Contact | 5633598271 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul R Black Dds Pc 2525 Kimberly Rd Ste 3 Bettendorf IA 52722-3538 Ph: (563) 359-8271 | Paul R Black Dds Pc 2525 Kimberly Rd Ste 3 Bettendorf IA 52722-3538 Ph: (563) 359-8271 |
| NPI Number | 1487192407 |
|---|---|
| Provider Enumeration Date | 02/09/2017 |
| Last Update Date | 03/04/2017 |
| Medicare PECOS PAC ID | 0143598300 |
|---|---|
| Medicare Enrollment ID | O20170613001309 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487192407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7060 (Iowa) | Primary |
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