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Individual

DR. GARY VANHOFWEGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
18 WEST 4TH ST, SPENCER, IA 51301
(712) 262-4751
(712) 262-7278
Mailing address
18 WEST 4TH ST, PO BOX 224, SPENCER, IA 51301
(712) 262-4751
(712) 262-7278

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
06343
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0150375
IA
01
06343
BC/BS OF NJ
NJ
01
17805
BC/BS OF IA
IA
01
3144570
BC/BS OF TN
TN
01
413707
BC/BS OF KS
KS
01
869122
UNITED CONCORDIA
PA
Enumeration date
11/03/2006
Last updated
07/08/2007
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