Individual
DR. MICHAEL KENNETH MACAITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
214 E ERIE ST, MISSOURI VALLEY, IA 51555-1533
(712) 642-4136
(712) 642-3664
Mailing address
214 E ERIE ST, MISSOURI VALLEY, IA 51555-1533
(712) 642-4136
(712) 642-3664
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7735
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2152637
—
IA
Enumeration date
09/28/2006
Last updated
07/09/2007
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