| Fayette Dental Clinic | |
|
143 S Main St Fayette IA 52142-7701 | |
| (563) 425-4211 | |
| Not Available |
| Full Name | Fayette Dental Clinic |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 143 S Main St, Fayette, Iowa |
| Authorized Official Name and Position | Charles Lee (PRESIDENT) |
| Authorized Official Contact | 5634254211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fayette Dental Clinic 143 S Main St Fayette IA 52142-7701 Ph: () - | Fayette Dental Clinic 143 S Main St Fayette IA 52142-7701 Ph: (563) 425-4211 |
| NPI Number | 1639444235 |
|---|---|
| Provider Enumeration Date | 03/14/2012 |
| Last Update Date | 03/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639444235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 08790 (Iowa) | Primary |