Healthcare Provider Details

I. General information

NPI: 1932202140
Provider Name (Legal Business Name): ANN WEGENER ROMANOWSKI DSD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 MALL DRIVE
IOWA CITY IA
52240
US

IV. Provider business mailing address

1517 MALL DRIVE
IOWA CITY IA
52240
US

V. Phone/Fax

Practice location:
  • Phone: 319-337-5752
  • Fax: 319-351-8348
Mailing address:
  • Phone: 319-337-5752
  • Fax: 319-351-8348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number7259
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: