Organization
NORTH LIBERTY DENTAL SERVICES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA BEIREIS CARNEOL DDS (OWNER)
(319) 626-2300
Entity
Organization
Contact information
Practice address
525 W CHERRY ST, NORTH LIBERTY, IA 52317-9797
(319) 626-2300
(319) 626-3503
Mailing address
525 W CHERRY ST, NORTH LIBERTY, IA 52317-9797
(319) 626-2300
(319) 626-3503
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
07594
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0179390
—
IA
01
—
49921
FEDERAL ID
IA
Enumeration date
05/15/2008
Last updated
05/15/2008
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