| Northeast Iowa Dental Professional Corporation | |
|
18 1st Ave Nw Waukon IA 52172 | |
| (563) 568-4528 | |
| (563) 568-6144 |
| Full Name | Northeast Iowa Dental Professional Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 18 1st Ave Nw, Waukon, Iowa |
| Authorized Official Name and Position | Judy Sue Kurth (OFFICE MANAGER) |
| Authorized Official Contact | 5635684528 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Iowa Dental Professional Corporation 18 1st Ave Nw Waukon IA 52172 Ph: (563) 568-4528 | Northeast Iowa Dental Professional Corporation 18 1st Ave Nw Waukon IA 52172 Ph: (563) 568-4528 |
| NPI Number | 1720173990 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 12/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720173990 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |