Dental Studio Of Iowa Pc | |
5495 Nw 100th Street Johnston IA 50131 | |
(515) 707-4383 | |
Not Available |
Full Name | Dental Studio Of Iowa Pc |
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Speciality | Dentist - General Practice |
Location | 5495 Nw 100th Street, Johnston, Iowa |
Authorized Official Name and Position | Connor Elmitt (PRESIDENT) |
Authorized Official Contact | 5157074383 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Dental Studio Of Iowa Pc 905 Nw Harvest Dr Grimes IA 50111-2300 Ph: (515) 707-4383 | Dental Studio Of Iowa Pc 5495 Nw 100th Street Johnston IA 50131 Ph: (515) 707-4383 |
NPI Number | 1982182606 |
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Provider Enumeration Date | 08/03/2018 |
Last Update Date | 08/03/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982182606 | NPI | - | NPPES |
1013329978 | Medicaid | AK | |
1942615232 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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