Organization
THE CEDAR RAPIDS DENTAL CENTER
Active
Other names
The Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA M SHANNON (OFFICE MANAGER)
(319) 365-0534
Entity
Organization
Contact information
Practice address
815 38TH ST SE, CEDAR RAPIDS, IA 52403-4300
(319) 365-0534
(319) 297-7417
Mailing address
815 38TH ST SE, CEDAR RAPIDS, IA 52403-4300
(319) 365-0534
(319) 297-7417
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7446
IA
1223G0001X
General Practice Dentistry
Primary
7588
IA
1223G0001X
General Practice Dentistry
7949
IA
1223P0700X
Prosthodontics
7446
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0084855
—
IA
05
—
0280362
—
IA
05
—
0281063
—
IA
Enumeration date
02/28/2007
Last updated
09/11/2025
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