| |
135 1st Street Nw Box 278 Primghar IA 51245 | |
(712) 957-2460 | |
Not Available |
Full Name | |
---|---|
Speciality | Dentist |
Location | 135 1st Street Nw, Primghar, Iowa |
Authorized Official Name and Position | Jean E Irwin (DENTIST) |
Authorized Official Contact | 7129572460 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Box 278 135 1st Street Nw Primghar IA 51245 Ph: (712) 957-2460 | 135 1st Street Nw Box 278 Primghar IA 51245 Ph: (712) 957-2460 |
NPI Number | 1649387333 |
---|---|
Provider Enumeration Date | 08/25/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649387333 | NPI | - | NPPES |
1152553 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 06326 (Iowa) | Primary |