| Eastern Iowa Oral And Maxillofacial Surgery | |
|
4150 Edgewood Road Ne Suite 100 Cedar Rapids IA 52402-0609 | |
| (319) 366-8277 | |
| (319) 366-7091 |
| Full Name | Eastern Iowa Oral And Maxillofacial Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 4150 Edgewood Road Ne, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Suzanne J. Stewart (OFFICE MANAGER) |
| Authorized Official Contact | 3193668277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Iowa Oral And Maxillofacial Surgery 4150 Edgewood Road Ne Suite 100 Cedar Rapids IA 52402-0609 Ph: (319) 366-8277 | Eastern Iowa Oral And Maxillofacial Surgery 4150 Edgewood Road Ne Suite 100 Cedar Rapids IA 52402-0609 Ph: (319) 366-8277 |
| NPI Number | 1992962732 |
|---|---|
| Provider Enumeration Date | 05/20/2008 |
| Last Update Date | 12/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992962732 | NPI | - | NPPES |
| 08986 | Other | IA | BENJAMIN L. FULLER LICENSE NUMBER |
| 1265727150 | Other | IA | JAROM E. MAURER NPI |
| 1689802910 | Other | IA | BENJAMIN L. FULLER NPI |
| 09173 | Other | IA | JAROM E. MAURER LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 08986 (Iowa) | Primary |
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