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Organization
CORNERSTONE DENTAL OF IOWA,LLC
Active
Organization
CORNERSTONE DENTAL OF IOWA,LLC
Active
Other names
Cornerstone Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN HUSSONG DDS (CHAIRPERSON)
(515) 984-6001
Entity
Organization
Contact information
Practice address
201 N 3RD STREET, UNIT F, POLK CITY, IA 50226
(515) 984-6001
Mailing address
PO BOX 170, POLK CITY, IA 50226-0170
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08491
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0080200
—
IA
Enumeration date
02/26/2010
Last updated
02/26/2010
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