Organization
INDIAN CREEK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES WALKER DDS (OWNER/DENTIST)
(319) 366-2451
Entity
Organization
Contact information
Practice address
601 TAMA ST, MARION, IA 52302-4804
(319) 366-2451
(319) 366-1602
Mailing address
601 TAMA ST, MARION, IA 52302-4804
(319) 366-2451
(319) 366-1602
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6480
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447340815
—
IA
Enumeration date
05/25/2012
Last updated
05/04/2020
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