Organization
MOFFITT DENTAL CENTER
Active
Other names
Michael W. Moffitt DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL WALTER MOFFITT DDS (OWNER/DOCTOR)
(515) 448-4852
Entity
Organization
Contact information
Practice address
422 W BROADWAY ST, EAGLE GROVE, IA 50533-1704
(515) 448-4852
(515) 448-3533
Mailing address
422 W BROADWAY ST, EAGLE GROVE, IA 50533-1704
(515) 448-4852
(515) 448-3533
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6102
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010720525
AMERICAN DENTAL ASSOCIATION
IA
05
—
0148007
—
IA
01
—
14800
WELLMARK BLUE CROSS/BLUE SHIELD
IA
01
—
1613
AMERICAN COLLEGE OF PROSTHODONTICS
IA
Enumeration date
05/20/2008
Last updated
05/20/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us