Individual
DR. KIRK ALAN MARCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
205 S L6TH ST, CLARINDA, IA 51632-2107
(712) 542-4015
Mailing address
205 S L6TH ST, CLARINDA, IA 51632-2107
(712) 542-4015
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6425
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164798
—
IA
Enumeration date
01/10/2007
Last updated
07/09/2007
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