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General NPI Number Information
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NPI Number | 1356097224
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Entity Type | Organization
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Legal Business Name | MOBILE DENTAL CARE OF IOWA
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 2769 BLACK ROAD
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City | JOLIET
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State | IL
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Zip | 60435
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Country | US
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Telephone | 888-970-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 2314 S ROUTE 59 STE 384
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City | PLAINFIELD
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State | IL
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Zip | 60586-7756
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Country | US
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Telephone | 888-970-3400
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANK CAMARDA
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Credential |
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Telephone | 888-970-3400
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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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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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