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Organization
ORAL SURGERY OF IOWA PLLC
Active
Organization
ORAL SURGERY OF IOWA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANN RICE (CREDENTIALING MANAGER)
(609) 315-3851
Entity
Organization
Contact information
Practice address
5350 KIRKWOOD BLVD SW STE 700, CEDAR RAPIDS, IA 52404-5234
(319) 366-0600
Mailing address
2970 BRANDYWINE RD STE 200, ATLANTA, GA 30341-5549
(770) 692-1000
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
261QD0000X
Dental Clinic/Center
—
NULL
Other
Enumeration date
01/19/2023
Last updated
01/19/2023
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