Organization
OCULOFACIAL AESTHETICS, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL REPP MD (OWNER)
(563) 213-5080
Entity
Organization
Contact information
Practice address
5335 EASTERN AVE, SUITE C, DAVENPORT, IA 52807-2788
(563) 213-5080
Mailing address
5335 EASTERN AVE, SUITE C, DAVENPORT, IA 52807-2788
(563) 213-5080
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD-42656
IA
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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