Organization
KEVIN G. WITT, DDS PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN WITT DDS (DENTIST)
(319) 530-2688
Entity
Organization
Contact information
Practice address
1350 BOYSON RD, HIAWATHA, IA 52233-2211
(319) 395-0159
Mailing address
1355 ANTLER DR, NORTH LIBERTY, IA 52317-2315
(319) 530-2688
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000338
—
IA
Enumeration date
06/26/2013
Last updated
12/18/2013
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