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General NPI Number Information
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NPI Number | 1053851907
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Entity Type | Organization
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Legal Business Name | DENALI DENTAL PLLC
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Dates
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Enumeration Date | 02/26/2017
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Last Update Date | 02/26/2017
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Provider Practice Location Address
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Address Line | 525 TIMBERLAND DR
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City | STORY CITY
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State | IA
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Zip | 50248-8793
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Country | US
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Telephone | 515-337-2510
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Fax |
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Provider Business Mailing Address
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Address Line | 3305 SEDWICK ST
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City | AMES
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State | IA
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Zip | 50010-1157
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Country | US
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Telephone | 515-520-1367
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Fax |
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Authorized Official
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Title or Position | OWNER, OPERATOR
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Name | DR. DANIEL JOSEPH BINKOWSKI
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Credential | DDS
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Telephone | 515-337-2510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 09236
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License Number State | IA
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