Individual
DR. BRUCE ANTHONY D'AGOSTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
402 W PLATT ST, MAQUOKETA, IA 52060-2161
(563) 652-3811
(563) 652-3187
Mailing address
402 W PLATT ST, MAQUOKETA, IA 52060-2161
(563) 652-3811
(563) 652-3187
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6471
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164376
—
IA
Enumeration date
08/03/2005
Last updated
09/19/2007
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