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121 Ne 18th St Ste C Ankeny IA 50021-4697 | |
| (515) 963-3339 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 121 Ne 18th St Ste C, Ankeny, Iowa |
| Authorized Official Name and Position | Erika Ellen Peddicord (OWNER) |
| Authorized Official Contact | 5159633339 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
121 Ne 18th St Ste C Ankeny IA 50021-4697 Ph: (515) 963-3339 | 121 Ne 18th St Ste C Ankeny IA 50021-4697 Ph: (515) 963-3339 |
| NPI Number | 1134437080 |
|---|---|
| Provider Enumeration Date | 09/14/2010 |
| Last Update Date | 09/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134437080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 08497 (Iowa) | Primary |
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