| Glass Road Family Dentistry | |
|
4250 Glass Rd Ne Ste 220 Cedar Rapids IA 52402-2500 | |
| (319) 395-7207 | |
| (319) 395-0143 |
| Full Name | Glass Road Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4250 Glass Rd Ne Ste 220, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Sharon L Loso (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5635520058 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glass Road Family Dentistry 40 Main St Ste 100 Dubuque IA 52001-7654 Ph: (563) 582-1448 | Glass Road Family Dentistry 4250 Glass Rd Ne Ste 220 Cedar Rapids IA 52402-2500 Ph: (319) 395-7207 |
| NPI Number | 1629638523 |
|---|---|
| Provider Enumeration Date | 06/13/2019 |
| Last Update Date | 07/29/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629638523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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