| Elite Dental, P.c. | |
|
1410 9th St Se Dyersville IA 52040-2335 | |
| (563) 875-8386 | |
| (563) 875-8386 |
| Full Name | Elite Dental, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1410 9th St Se, Dyersville, Iowa |
| Authorized Official Name and Position | Julie Ann Koch-womer (BUSINESS OWNER) |
| Authorized Official Contact | 5638758386 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Dental, P.c. 1410 9th St Se Dyersville IA 52040-2335 Ph: (563) 875-8386 | Elite Dental, P.c. 1410 9th St Se Dyersville IA 52040-2335 Ph: (563) 875-8386 |
| NPI Number | 1134248826 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134248826 | NPI | - | NPPES |
| 1274142 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 08093 (Iowa) | Primary |
Stone Creek Dental Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 613 16th Ave Se, Dyersville, IA 52040 Phone: 563-875-9180 Fax: 563-875-9341 | |
Stone Creek Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 613 16th Ave Se, Dyersville, IA 52040 Phone: 563-875-9180 Fax: 563-875-9431 |