| Southwest Orthodontic Associates, Pc | |
|
40 Northcrest Dr Ste 2 Council Bluffs IA 51503-1698 | |
| (712) 323-7589 | |
| (712) 323-8255 |
| Full Name | Southwest Orthodontic Associates, Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 40 Northcrest Dr Ste 2, Council Bluffs, Iowa |
| Authorized Official Name and Position | Wendell R. Stuntz (OWNER) |
| Authorized Official Contact | 7123237589 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Orthodontic Associates, Pc 40 Northcrest Dr Ste 2 Council Bluffs IA 51503-1698 Ph: (712) 323-7589 | Southwest Orthodontic Associates, Pc 40 Northcrest Dr Ste 2 Council Bluffs IA 51503-1698 Ph: (712) 323-7589 |
| NPI Number | 1306003520 |
|---|---|
| Provider Enumeration Date | 05/16/2008 |
| Last Update Date | 05/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306003520 | NPI | - | NPPES |
| 1689868945 | Medicaid | IA | |
| 1508943986 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 06149 (Iowa) | Primary |
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