| Spring Park Oral And Maxillofacial Surgeons, P.c. | |
|
1111 Canal Shore Dr Sw Le Claire IA 52753-7602 | |
| (563) 355-1034 | |
| Not Available |
| Full Name | Spring Park Oral And Maxillofacial Surgeons, P.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1111 Canal Shore Dr Sw, Le Claire, Iowa |
| Authorized Official Name and Position | Paul R Smith (PRESIDENT/OWNER) |
| Authorized Official Contact | 5633591601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spring Park Oral And Maxillofacial Surgeons, P.c. 5345 Spring St Davenport IA 52807-2764 Ph: (563) 359-1601 | Spring Park Oral And Maxillofacial Surgeons, P.c. 1111 Canal Shore Dr Sw Le Claire IA 52753-7602 Ph: (563) 355-1034 |
| NPI Number | 1386067817 |
|---|---|
| Provider Enumeration Date | 02/04/2014 |
| Last Update Date | 04/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386067817 | NPI | - | NPPES |
| 87346 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 8664 (Iowa) | Primary |
Leclaire Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 S Cody Rd, Le Claire, IA 52753 Phone: 563-289-3249 | |
Riverview Dental Specialists Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1111 Canal Shore Dr, Le Claire, IA 52753 Phone: 563-355-1034 Fax: 563-359-1824 |