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Individual

DR. DAPHNE ANN PUDENZ

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
405 S CLARK ST, SUITE 100, CARROLL, IA 51401-3065
(712) 792-1500
(712) 792-1407
Mailing address
405 S CLARK ST, SUITE 100, CARROLL, IA 51401-3065
(712) 792-1500
(712) 792-1407

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32844
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2186528
IA
Enumeration date
11/04/2005
Last updated
07/08/2007
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