Healthcare Provider Details

I. General information

NPI: 1003732553
Provider Name (Legal Business Name): KEVIN DUQUE, DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 TORNADO DR
STORM LAKE IA
50588-2048
US

IV. Provider business mailing address

1105 W 4TH ST
STORM LAKE IA
50588-1631
US

V. Phone/Fax

Practice location:
  • Phone: 712-730-3015
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEVIN DUQUE
Title or Position: OWNER
Credential: DDS
Phone: 712-730-1885