Organization
PRAIRIE ENDODONTICS PLC
Active
Other names
Prairie Endodontics PLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL MCCUNNIFF D.D.S. (OWNER)
(319) 939-4105
Entity
Organization
Contact information
Practice address
1358 SE UNIVERSITY AVE, WAUKEE, IA 50263-8933
(515) 393-2556
(515) 393-6782
Mailing address
1358 SE UNIVERSITY AVE, WAUKEE, IA 50263-8933
(515) 393-2556
(515) 393-6782
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
09/27/2022
Last updated
09/27/2022
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