Individual
DR. TIMOTHY VAN WINEGARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
222 EDGEWOOD RD NW, CEDAR RAPIDS, IA 52405-4472
(319) 396-8364
(319) 396-5800
Mailing address
222 EDGEWOOD RD NW, CEDAR RAPIDS, IA 52405-4472
(319) 396-8364
(319) 396-5800
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5806
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0142687
—
IA
Enumeration date
02/01/2011
Last updated
02/01/2011
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