Organization
SOUTHWEST IOWA DENTAL ASSOCIATES INC
Active
Other names
Southwest Iowa Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JILLIAN TRAVIS (OWNER)
(712) 246-2180
Entity
Organization
Contact information
Practice address
1213 W NISHNA RD, SHENANDOAH, IA 51601-2115
(712) 246-2180
(712) 246-1683
Mailing address
1213 W NISHNA RD, SHENANDOAH, IA 51601-2115
(712) 246-2180
(712) 246-1683
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5587
IA
Other
Enumeration date
03/03/2011
Last updated
01/29/2020
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