Healthcare Provider Details
I. General information
NPI: 1275732968
Provider Name (Legal Business Name): MARIE EVE ASSELIN DMD MSC FRCDC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/13/2007
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
322 S DENTAL SCIENCE BLDG
IOWA CITY IA
52242-1001
US
IV. Provider business mailing address
257 S DENTAL SCIENCE BLDG
IOWA CITY IA
52242-1001
US
V. Phone/Fax
- Phone: 319-335-7440
- Fax: 319-335-7451
- Phone: 319-335-7431
- Fax: 319-335-7155
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0106X |
| Taxonomy | Oral and Maxillofacial Pathology Dentistry |
| License Number | 40101 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: