Individual
DR. MICHAEL T LETKEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3430 KIMBALL AVE, WATERLOO, IA 50702
(319) 234-1210
(319) 234-4671
Mailing address
3430 KIMBALL AVE, WATERLOO, IA 50702
(319) 234-1210
(319) 234-4671
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7695
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0106302
—
IA
01
—
14545
WELLMARK BCBS
IA
Enumeration date
02/14/2007
Last updated
07/08/2007
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