| Contemporary Periodontics Pc | |
|
3900 River Ridge Drive Ne Suite A Cedar Rapids IA 52402-7599 | |
| (319) 363-9880 | |
| (319) 363-8386 |
| Full Name | Contemporary Periodontics Pc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 3900 River Ridge Drive Ne, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Truman Christopher Johnson (PRESIDENT) |
| Authorized Official Contact | 3193639880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Contemporary Periodontics Pc 3900 River Ridge Drive Ne Suite A Cedar Rapids IA 52402-7599 Ph: (319) 363-9880 | Contemporary Periodontics Pc 3900 River Ridge Drive Ne Suite A Cedar Rapids IA 52402-7599 Ph: (319) 363-9880 |
| NPI Number | 1528135944 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 06/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528135944 | NPI | - | NPPES |
| 00980081 | Other | UNITED CONCORDIA | |
| 46932 | Other | IA | WELLMARK BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 7959 (Iowa) | Primary |
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