| Patera Family Dentistry | |
|
700 E 2nd St Ida Grove IA 51445-1601 | |
| (712) 364-3101 | |
| (712) 364-3102 |
| Full Name | Patera Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 700 E 2nd St, Ida Grove, Iowa |
| Authorized Official Name and Position | Laura M Parks (OWNER) |
| Authorized Official Contact | 7123643101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Patera Family Dentistry 700 E 2nd St Ida Grove IA 51445-1601 Ph: (712) 364-3101 | Patera Family Dentistry 700 E 2nd St Ida Grove IA 51445-1601 Ph: (712) 364-3101 |
| NPI Number | 1548437874 |
|---|---|
| Provider Enumeration Date | 05/15/2008 |
| Last Update Date | 05/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548437874 | NPI | - | NPPES |
| 0465203 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 08317 (Iowa) | Primary |