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Organization
KIMBERLY PARK DENTAL ASSOCIATES
Active
Organization
KIMBERLY PARK DENTAL ASSOCIATES
Active
Other names
Marc C Slivken David A Johnson Thomas A Thol
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS WILLIAM THUL DDS (PRESIDENT DENTIST)
(563) 359-3494
Entity
Organization
Contact information
Practice address
3512 JERSEY RIDGE RD, DAVENPORT, IA 52807-3332
(563) 359-3494
Mailing address
3512 JERSEY RIDGE RD, DAVENPORT, IA 52807-3332
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0096222
JOHNSON
IA
01
—
0099382
SLIVKEN
IA
01
—
709842
BLUE CROSS T
IA
01
—
710728
BLUE CROSS S
IA
01
—
755644
BLUE CROSS J
IA
Enumeration date
10/10/2006
Last updated
08/22/2020
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