Healthcare Provider Details

I. General information

NPI: 1013915131
Provider Name (Legal Business Name): DAVID A. GIMER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date: 03/16/2006
Reactivation Date: 03/20/2006

III. Provider practice location address

922 WASHINGTON AVE
IOWA FALLS IA
50126-2011
US

IV. Provider business mailing address

922 WASHINGTON AVE
IOWA FALLS IA
50126-2011
US

V. Phone/Fax

Practice location:
  • Phone: 641-648-4237
  • Fax: 641-648-4239
Mailing address:
  • Phone: 641-648-4237
  • Fax: 641-648-4239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number06132
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: