Healthcare Provider Details

I. General information

NPI: 1164303624
Provider Name (Legal Business Name): MAGGIE JOANNE MCGLAUGHLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S CLINTON ST
IOWA CITY IA
52240-4105
US

IV. Provider business mailing address

608 TIPPERARY RD
IOWA CITY IA
52246-2789
US

V. Phone/Fax

Practice location:
  • Phone: 612-725-2000
  • Fax:
Mailing address:
  • Phone: 319-930-9006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number15635
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: