Organization
EPWORTH FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM DAVID KISSELL DDS (PRESIDENT)
(563) 876-3396
Entity
Organization
Contact information
Practice address
208 N CENTER AVE, EPWORTH, IA 52045-7741
(563) 876-3396
(563) 876-3396
Mailing address
208 N CENTER AVE, EPWORTH, IA 52045-7741
(563) 876-3396
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
06878
IA
Other
Enumeration date
04/08/2010
Last updated
04/08/2010
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