| White Pine Dental Group Pllc | |
|
2105 Pine St Harlan IA 51537 | |
| (712) 755-5342 | |
| (712) 755-5666 |
| Full Name | White Pine Dental Group Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2105 Pine St, Harlan, Iowa |
| Authorized Official Name and Position | Phillip L Markham (OWNER/DENTIST) |
| Authorized Official Contact | 7127555342 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| White Pine Dental Group Pllc 2105 Pine St Harlan IA 51537 Ph: (712) 755-5342 | White Pine Dental Group Pllc 2105 Pine St Harlan IA 51537 Ph: (712) 755-5342 |
| NPI Number | 1043443260 |
|---|---|
| Provider Enumeration Date | 09/04/2009 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043443260 | NPI | - | NPPES |
| 1487883948 | Medicaid | IA | |
| 1639364383 | Medicaid | IA | |
| 1356457535 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7374 (Iowa) | Primary |
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