Organization
HERITAGE DENTAL LLC
Active
Other names
James M Maixner DDS
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MICHAEL MAIXNER DDS (MANAGER)
(319) 352-5222
Entity
Organization
Contact information
Practice address
1400 10TH AVE SW, WAVERLY, IA 50677-3752
(319) 352-5222
(319) 352-5225
Mailing address
1400 10TH AVE SW, P.O. BOX 854, WAVERLY, IA 50677-3752
(319) 352-5222
(319) 352-5225
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
06793
IA
Other
Enumeration date
10/28/2008
Last updated
07/06/2009
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