Organization
IOWA PEDIATRIC DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD CRAIG PETERSON JR. D.D.S. (DOCTOR/OWNER)
(319) 351-5439
Entity
Organization
Contact information
Practice address
501 12TH AVE, SUITE 202, CORALVILLE, IA 52241-1774
(319) 351-5439
(319) 354-0491
Mailing address
501 12TH AVE, SUITE 202, CORALVILLE, IA 52241-1774
(319) 351-5439
(319) 354-0491
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
08193
IA
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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