| Iowa Pediatric Dental Center | |
|
501 12th Ave Suite 202 Coralville IA 52241-1774 | |
| (319) 351-5439 | |
| (319) 354-0491 |
| Full Name | Iowa Pediatric Dental Center |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 501 12th Ave, Coralville, Iowa |
| Authorized Official Name and Position | Donald Craig Peterson (DOCTOR/OWNER) |
| Authorized Official Contact | 3193515439 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Iowa Pediatric Dental Center 501 12th Ave Suite 202 Coralville IA 52241-1774 Ph: (319) 351-5439 | Iowa Pediatric Dental Center 501 12th Ave Suite 202 Coralville IA 52241-1774 Ph: (319) 351-5439 |
| NPI Number | 1639595952 |
|---|---|
| Provider Enumeration Date | 03/11/2014 |
| Last Update Date | 03/11/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639595952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 08193 (Iowa) | Primary |
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