Organization
SPRING PARK ORAL AND MAXILLOFACIAL SURGEONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIE TESHAK (MANAGER)
(563) 359-1601
Entity
Organization
Contact information
Practice address
407 S 4TH ST, CLINTON, IA 52732-4512
(563) 243-4406
(563) 243-8534
Mailing address
407 S 4TH ST, CLINTON, IA 52732-4512
(563) 243-4406
(563) 243-8534
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/17/2006
Last updated
08/22/2020
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