Organization
CORNERSTONE DENTAL OF IOWA,LLC
Active
Other names
Cornerstone Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN HUSSONG DDS (CHAIRPERSON)
(515) 984-6001
Entity
Organization
Contact information
Practice address
201 N 3RD STREET, UNIT F, POLK CITY, IA 50226
(515) 984-6001
Mailing address
PO BOX 170, POLK CITY, IA 50226-0170
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08491
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0080200
—
IA
Enumeration date
02/26/2010
Last updated
02/26/2010
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