Organization
DOUGLAS J RECKER
Active
Parent organization
DOUGLAS J RECKER
Other names
Boyson Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
DOUGLAS J RECKER
Authorized official
DR. DOUGLAS JAMES RECKER DDS (OWNER DENTIST)
(319) 393-4019
Entity
Organization
Contact information
Practice address
1475 BOYSON RD, HIAWATHA, IA 52233-2339
(319) 393-4019
(319) 378-2924
Mailing address
1475 BOYSON ROAD, HIAWATHA, IA 52233-2339
(319) 393-4019
(319) 378-2924
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7455
IA
1223G0001X
General Practice Dentistry
7638
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0083212
—
IA
01
—
0200759
MEDICAID GROUP
—
05
—
1123307
—
IA
Enumeration date
05/27/2006
Last updated
06/19/2008
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