Organization
MATTHEW KUBOVICH
Active
Other names
Des Moines Pediatric Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW PERRY KUBOVICH D.D.S. (OWNER)
(515) 225-0066
Entity
Organization
Contact information
Practice address
4949 WESTOWN PKWY, SUITE 150, WEST DES MOINES, IA 50266-6702
(515) 225-0066
(515) 226-0998
Mailing address
4949 WESTOWN PKWY, STE 150, WEST DES MOINES, IA 50266-6702
(515) 225-0066
(515) 226-0998
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1291575
—
IA
01
—
1745344
UNITED CONCORDIA
IA
01
—
35184
BLUE CROSS BLUE SHIELD
IA
Enumeration date
05/15/2008
Last updated
11/30/2010
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