Organization
DEWITT DENTAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY A SIEGEL (BUSINESS MANAGER)
(563) 659-3411
Entity
Organization
Contact information
Practice address
907 11TH ST, DE WITT, IA 52742-1207
(563) 659-3411
(563) 659-2831
Mailing address
907 11TH ST, DE WITT, IA 52742-1207
(563) 659-3411
(563) 659-2831
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07420
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1283150
—
IA
Enumeration date
01/24/2007
Last updated
08/22/2020
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