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Organization
NORTH LIBERTY DENTAL SERVICES P.C.
Active
Organization
NORTH LIBERTY DENTAL SERVICES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA BEIREIS CARNEOL DDS (OWNER)
(319) 626-2300
Entity
Organization
Contact information
Practice address
525 W CHERRY ST, NORTH LIBERTY, IA 52317-9797
(319) 626-2300
(319) 626-3503
Mailing address
525 W CHERRY ST, NORTH LIBERTY, IA 52317-9797
(319) 626-2300
(319) 626-3503
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
07594
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0179390
—
IA
01
—
49921
FEDERAL ID
IA
Enumeration date
05/15/2008
Last updated
05/15/2008
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