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Organization

VITZTHUM FAMILY DENTISTRY

Active
Other names
Ridgeway Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALEX VITZTHUM DDS (DENTIST)
(515) 890-7989
Entity
Organization

Contact information

Practice address
1866 W RIDGEWAY AVE, WATERLOO, IA 50701-4546
(319) 235-0164
Mailing address
1866 W RIDGEWAY AVE, WATERLOO, IA 50701-4546
(319) 235-0164

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013447515
NPPES
IA
01
1063039618
NPPES
IA
01
1467070060
NPPES
IA
01
1730673146
NPPES
IA
Enumeration date
07/18/2024
Last updated
07/18/2024
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