Individual
DACODA TENTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 JONES ST STE 108, DUBUQUE, IA 52001-7615
(563) 581-9353
Mailing address
530 S GRANDVIEW AVE, DUBUQUE, IA 52003-7265
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
120259
IA
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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