Organization
SMILE SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMY REBECCA GROELTZ DDS (PRESIDENT/DENTIST)
(319) 752-1600
Entity
Organization
Contact information
Practice address
210 S 5TH ST, BURLINGTON, IA 52601-5619
(319) 752-1600
(319) 752-1610
Mailing address
210 S 5TH ST, BURLINGTON, IA 52601-5619
(319) 752-1600
(319) 752-1610
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8298
IA
Other
Enumeration date
05/15/2008
Last updated
05/15/2008
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