Organization
TIMOTHY V WINEGARDEN DDS MSD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY V WINEGARDEN DDS MSD PC (ORTHODONTIST PRESIDENT)
(319) 396-8364
Entity
Organization
Contact information
Practice address
222 EDGEWOOD RD NW, CEDAR RAPIDS, IA 52405-4472
(319) 396-8364
(319) 396-5800
Mailing address
222 EDGEWOOD RD NW, CEDAR RAPIDS, IA 52405-4472
(319) 396-8364
(319) 396-5800
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5806
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0142687
—
IA
Enumeration date
03/13/2007
Last updated
08/22/2020
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