Organization
DR. RICO BERTAGNOLLI FAMILY DENTISTRY,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICO L BERTAGNOLLI D.D.S. (DENTIST)
(515) 262-9581
Entity
Organization
Contact information
Practice address
921 E 23RD ST, DES MOINES, IA 50317-6515
(515) 262-9581
Mailing address
921 E 23RD ST, DES MOINES, IA 50317-6515
(515) 262-9581
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7377
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699855254
—
IA
Enumeration date
06/03/2008
Last updated
06/03/2008
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