Organization
JERRY W. KAALBERG, DDS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY W. KAALBERG DDS (PRESIDENT)
(319) 364-7111
Entity
Organization
Contact information
Practice address
2727 1ST AVE SE, CEDAR RAPIDS, IA 52402-4844
(319) 364-7111
(319) 364-1726
Mailing address
2727 1ST AVE SE, CEDAR RAPIDS, IA 52402-4844
(319) 364-7111
(319) 364-1726
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
5773
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060004
—
IA
Enumeration date
08/16/2006
Last updated
08/22/2020
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