Individual
CARLA KUCIREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1700 E SUMMIT ST, RED OAK, IA 51566-1711
(712) 623-5404
(712) 623-5404
Mailing address
1700 E SUMMIT ST, RED OAK, IA 51566-1711
(712) 623-5404
(712) 623-5231
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
09081
IA
122300000X
Dentist
DDS-09081
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013215805
—
IA
Enumeration date
06/04/2014
Last updated
05/24/2022
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