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Organization
SMILES ON MAIN
Active
Organization
SMILES ON MAIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALVADOR D ATIENZA DDS (PRESIDENT)
(563) 652-4133
Entity
Organization
Contact information
Practice address
119 SOUTH MAIN, STE 1, MAQUOKETA, IA 52060
(563) 652-4133
Mailing address
119 SOUTH MAIN, STE 1, MAQUOKETA, IA 52060
(563) 652-4133
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7745
IA
122300000X
Dentist
8368
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0116848
—
IA
05
—
0464354
—
IA
01
—
8368
DELTA
—
Enumeration date
05/27/2006
Last updated
01/05/2009
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