Organization
JAMES A. KOUBA, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES A KOUBA D.D.S. (PRESIDENT)
(641) 664-1121
Entity
Organization
Contact information
Practice address
107 S PINE ST, BLOOMFIELD, IA 52537-1519
(641) 664-1121
(641) 664-2107
Mailing address
107 S PINE ST, BLOOMFIELD, IA 52537-1519
(641) 664-1121
(641) 664-2107
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
06138
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128389
—
IA
Enumeration date
02/15/2007
Last updated
08/22/2020
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