Organization
NICHOLAS J. FANGMAN DDS
Active
Other names
Dr. Nicholas J. Fangman
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS J FANGMAN DDS (OWNER)
(712) 792-2630
Entity
Organization
Contact information
Practice address
1406 N US HIGHWAY 71, CARROLL, IA 51401
(712) 792-2630
(712) 792-5547
Mailing address
1406 N US HIGHWAY 71, CARROLL, IA 51401
(712) 792-2630
(712) 792-5547
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
07225
IA
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0042820
—
IA
Enumeration date
04/23/2008
Last updated
08/12/2022
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