| Oral Health Clinic Pc | |
|
1225 Copper Creek Dr Suite K Pleasant Hill IA 50327-7091 | |
| (515) 266-3700 | |
| (515) 266-3597 |
| Full Name | Oral Health Clinic Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1225 Copper Creek Dr Suite K, Pleasant Hill, Iowa |
| Authorized Official Name and Position | Chadwick Aaron Johnson (PRESIDENT) |
| Authorized Official Contact | 5152663700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral Health Clinic Pc 1225 Copper Creek Dr Suite K Pleasant Hill IA 50327-7091 Ph: (515) 266-3700 | Oral Health Clinic Pc 1225 Copper Creek Dr Suite K Pleasant Hill IA 50327-7091 Ph: (515) 266-3700 |
| NPI Number | 1053579201 |
|---|---|
| Provider Enumeration Date | 05/23/2008 |
| Last Update Date | 05/23/2008 |
| Medicare PECOS PAC ID | 4183925944 |
|---|---|
| Medicare Enrollment ID | O20151221000905 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053579201 | NPI | - | NPPES |
| 0462705 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 8353 (Iowa) | Primary |
| Provider Name | Chadwick A Johnson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1508978602 PECOS PAC ID: 3072814839 Enrollment ID: I20151221001031 |
Lakeside Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1286 Copper Creek Dr, Pleasant Hill, IA 50327 Phone: 515-263-1414 Fax: 515-263-0807 | |
Brandt Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5075 E University Ave Ste A, Pleasant Hill, IA 50327 Phone: 515-265-6484 | |
Cio,llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5890 Morning Star Ct., Pleasant Hill, IA 50327 Phone: 515-266-2154 Fax: 515-266-8065 |