| Samuel L. Koth, Dds, Pc | |
|
1220 21st Ave Rock Valley IA 51247-1420 | |
| (712) 476-2749 | |
| (712) 476-5374 |
| Full Name | Samuel L. Koth, Dds, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1220 21st Ave, Rock Valley, Iowa |
| Authorized Official Name and Position | Samuel Lee Koth (DENTIST/PRESIDENT) |
| Authorized Official Contact | 7124762749 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel L. Koth, Dds, Pc 1220 21st Ave Rock Valley IA 51247-1420 Ph: (712) 476-2749 | Samuel L. Koth, Dds, Pc 1220 21st Ave Rock Valley IA 51247-1420 Ph: (712) 476-2749 |
| NPI Number | 1760734263 |
|---|---|
| Provider Enumeration Date | 10/08/2012 |
| Last Update Date | 10/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760734263 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 08755 (Iowa) | Primary |
James A. Jespersen, Dds, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1220 21st Ave, Rock Valley, IA 51247 Phone: 712-476-2749 Fax: 712-476-5374 |