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Organization

ENT PROFESSIONAL SERVICES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS W DVORAK MD (PRESIDENT)
(563) 359-1646
Entity
Organization

Contact information

Practice address
3385 DEXTER CT, SUITE 101, DAVENPORT, IA 52807-3471
(563) 359-1646
(563) 344-6703
Mailing address
3385 DEXTER CT, SUITE 101, DAVENPORT, IA 52807-3471
(563) 359-1646
(563) 344-6703

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
02/01/2007
Last updated
11/21/2012
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