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Organization
IOWA ORAL AND MAXILLOFACIAL SURGEONS, PC
Active
Organization
IOWA ORAL AND MAXILLOFACIAL SURGEONS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANA GAIL WEIRICH (INSURANCE COORDINATOR)
(515) 327-1647
Entity
Organization
Contact information
Practice address
1469 29TH ST, WEST DES MOINES, IA 50266-1302
(515) 223-6529
(515) 223-5448
Mailing address
1469 29TH ST, WEST DES MOINES, IA 50266-1302
(515) 223-6529
(515) 223-5448
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
06447
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22178
MEDICARE PTAN
IA
Enumeration date
01/24/2006
Last updated
05/30/2008
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