MEDICARE: DR. JAMES MICHAEL HAWKS D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	7363	IA

General Provider Information

NPI Number	:	1518082965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES MICHAEL HAWKS D.D.S.

Provider Business Mailing Address
First Line	:	1200 VALLEY WEST DR STE 109
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1902
Country	:	US
Telephone Number	:	515-225-6665
Fax Number	:	515-225-0508

Provider Business Practice Location Address
First Line	:	1200 VALLEY WEST DR STE 109
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1902
Country	:	US
Telephone Number	:	515-225-6665
Fax Number	:	515-225-0508

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/08/2007

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