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General NPI Number Information
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NPI Number | 1205019296
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Entity Type | Organization
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Legal Business Name | DRS KOMMER AND STURDIVANT PC
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 125 VALLEY WEST DRIVE
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City | WEST DES MOINES
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State | IA
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Zip | 50265-3939
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Country | US
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Telephone | 515-225-9245
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Fax | 515-225-8162
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Provider Business Mailing Address
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Address Line | 125 VALLEY WEST DRIVE
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City | WEST DES MOINES
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State | IA
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Zip | 50265-3939
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Country | US
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Telephone | 515-225-9245
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Fax | 515-225-8162
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. DENNIS D KOMMER
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Credential | DDS MS
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Telephone | 515-225-9245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State | IA
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