| Tooth Emporium Inc | |
|
179 Bennett Avenue Council Bluffs IA 51503-5206 | |
| (712) 322-2231 | |
| (712) 322-6853 |
| Full Name | Tooth Emporium Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 179 Bennett Avenue, Council Bluffs, Iowa |
| Authorized Official Name and Position | William J Braymen (OWNER) |
| Authorized Official Contact | 7123222231 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tooth Emporium Inc 179 Bennett Avenue Council Bluffs IA 51503-5206 Ph: (712) 322-2231 | Tooth Emporium Inc 179 Bennett Avenue Council Bluffs IA 51503-5206 Ph: (712) 322-2231 |
| NPI Number | 1902914757 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902914757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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