Individual
CAROL LEE CLEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4551 FLEUR DR, DES MOINES, IA 50321-2331
(515) 287-2493
(515) 287-7948
Mailing address
3915 SW 29TH ST, DES MOINES, IA 50321-2044
(515) 256-7457
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7639
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1101790
—
IA
01
—
7639
STATE LICENSE NUMBER
IA
Enumeration date
11/29/2006
Last updated
07/09/2007
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