Organization
LAURA M PARKS, DDS
Active
Other names
Patera Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA M PARKS D.D.S. (OWNER)
(712) 364-3101
Entity
Organization
Contact information
Practice address
700 E 2ND ST, IDA GROVE, IA 51445-1601
(712) 364-3101
(712) 364-3102
Mailing address
700 E 2ND ST, IDA GROVE, IA 51445-1601
(712) 364-3101
(712) 364-3102
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08317
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0465203
—
IA
Enumeration date
05/15/2008
Last updated
05/15/2008
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