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General NPI Number Information
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NPI Number | 1306772892
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Entity Type | Organization
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Legal Business Name | ANAMOSA DENTAL ENTERPRISES PLLC
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 702 W MAIN ST
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City | ANAMOSA
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State | IA
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Zip | 52205-1636
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Country | US
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Telephone | 319-462-2531
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Fax |
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Provider Business Mailing Address
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Address Line | 3020 AURORA AVE
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City | SPIRIT LAKE
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State | IA
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Zip | 51360-7097
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHAUN O'NEILL
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Credential |
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Telephone | 608-289-2540
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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 |
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License Number State |
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