Organization
FAMILY SMILECARE CENTER
Active
Other names
Renee Maikon, DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RENEE ELAINE MAIKON DDS (DENTIST OWNER)
(319) 362-8657
Entity
Organization
Contact information
Practice address
1630 32ND ST NE, CEDAR RAPIDS, IA 52402
(319) 362-8657
(319) 362-1824
Mailing address
1630 32ND ST NE, CEDAR RAPIDS, IA 52402
(319) 362-8657
(319) 362-1824
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07308
IA
1223G0001X
General Practice Dentistry
08065
IA
1223G0001X
General Practice Dentistry
4870
IA
1223G0001X
General Practice Dentistry
7308
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0247759
—
IA
01
—
55943
BLUE CROSS
IA
Enumeration date
06/10/2006
Last updated
07/17/2008
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