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Organization

RW KOLARICH FAMILY DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROGER KOLARICH DDS (PRESIDENT)
(563) 864-7818
Entity
Organization

Contact information

Practice address
111 E TILDEN ST, POSTVILLE, IA 52162-9700
(563) 864-7818
Mailing address
111 E TILDEN, POSTVILLE, IA 52162-0635
(563) 864-7818

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6515
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0169227
IA
01
169227
DELTA DENTAL
IA
Enumeration date
06/03/2008
Last updated
06/03/2008
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