Individual
THOMAS JENEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
827 HOLTON DRIVE, LE MARS, IA 51031
(712) 546-4556
(712) 546-4568
Mailing address
827 HOLTON DRIVE, LE MARS, IA 51031
(712) 546-4556
(712) 546-4568
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07123
IA
1223G0001X
General Practice Dentistry
7123
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1036210
—
IA
01
—
23637
BLUE DENTAL
IA
01
—
236372
DELTA DENTAL
IA
Enumeration date
12/11/2006
Last updated
04/20/2018
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