Individual
DR. BRIAN WADE ANCELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
800 S 50TH ST, SUITE #105, WEST DES MOINES, IA 50265-5381
(515) 226-9800
(515) 226-9804
Mailing address
800 S 50TH ST, SUITE #105, WEST DES MOINES, IA 50265-5381
(515) 226-9800
(515) 226-9804
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08114
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045-0270
—
IA
01
—
221049
UNITED HEALTH CARE ID #
UT
01
—
270089317-00001
BLUE DENTAL OF IA #
IA
01
—
270089317-00001
DELTA OF MN PROVIDER #
MN
01
—
8114
DELTA DENTAL OF IOWA #
IA
Enumeration date
02/23/2007
Last updated
07/09/2007
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