Organization
EDP OF IOWA PC
Active
Parent organization
EDP OF IOWA PC
Other names
Dona Prince DDS
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDP OF IOWA PC
Authorized official
ROSEANNE BRUNENKANT (DIRECTOR OF INTEGRATIONS)
(312) 937-3619
Entity
Organization
Contact information
Practice address
4220 SERGEANT RD, SIOUX CITY, IA 51106-4648
(312) 800-1270
Mailing address
141 W JACKSON BLVD STE 210, CHICAGO, IL 60604-3048
(312) 937-3619
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/12/2019
Last updated
09/16/2019
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