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Organization

OAKDALE DENTAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHAD R HANNEMAN DDS (PRESIDENT)
(319) 545-6251
Entity
Organization

Contact information

Practice address
2441 CORAL CT STE 5, CORALVILLE, IA 52241-2872
(319) 545-6251
(319) 545-7265
Mailing address
2441 CORAL CT STE 5, CORALVILLE, IA 52241-2872
(319) 545-6251
(319) 545-7265

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8001
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1219089
IA
Enumeration date
07/23/2007
Last updated
07/23/2007
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