Organization
SOUTH DES MOINES DENTAL
Active
Other names
South Des Moines Dental Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE J CONNOLLY DDS (OWNER DENTIST)
(515) 285-9962
Entity
Organization
Contact information
Practice address
4401 SW 9TH ST, DES MOINES, IA 50315-3909
(515) 285-9962
Mailing address
4401 SW 9TH ST, DES MOINES, IA 50315-3909
(515) 285-9962
(515) 285-9699
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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