Organization
WESTERN IOWA DENTAL GROUP,PC
Active
Parent organization
WESTERN IOWA DENTAL GROUP, PC
Other names
Bayliss Park Dental Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN IOWA DENTAL GROUP, PC
Authorized official
MRS. BETTY KERGER (OFFICE MANAGER)
(712) 325-1544
Entity
Organization
Contact information
Practice address
114 1/2 S 6TH ST, COUNCIL BLUFFS, IA 51501-4234
(712) 325-1544
(712) 325-0420
Mailing address
1509 AVENUE G, COUNCIL BLUFFS, IA 51501-2516
(712) 325-1544
(712) 325-0420
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
07421
IA
Other
Enumeration date
03/06/2014
Last updated
03/06/2014
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