Organization
COMMUNITY HEALTH CENTER OF FORT DODGE INC.
Active
Other names
Community Health Center of Fort Dodge Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KATHY J WILKES MBA (CEO)
(515) 576-6500
Entity
Organization
Contact information
Practice address
330 AVENUE M, FORT DODGE, IA 50501-5739
(515) 576-6500
(515) 576-1951
Mailing address
126 N 10TH ST, FORT DODGE, IA 50501-3915
(515) 576-6500
(515) 576-1951
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0490383
—
IA
Enumeration date
04/14/2008
Last updated
09/17/2008
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