Organization
NORTH LIBERTY SMILES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PE CHANG DDS (OWNER)
(319) 665-3373
Entity
Organization
Contact information
Practice address
2 HAWKEYE DR STE 104, NORTH LIBERTY, IA 52317-8202
(319) 665-3373
Mailing address
6800 VISTA DEL NORTE RD NE APT 1526, ALBUQUERQUE, NM 87113-1364
(505) 980-3107
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093813354
NPI
NM
Enumeration date
03/13/2019
Last updated
03/13/2019
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