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General NPI Number Information
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NPI Number | 1417097445
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Entity Type | Organization
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Legal Business Name | MT PLEASANT DENTAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 304 N JEFFERSON ST
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City | MT PLEASANT
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State | IA
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Zip | 52641-1621
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Country | US
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Telephone | 319-385-8912
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Fax | 319-385-4532
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Provider Business Mailing Address
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Address Line | 304 N JEFFERSON ST
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City | MT PLEASANT
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State | IA
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Zip | 52641-1621
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Country | US
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Telephone | 319-385-8912
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Fax | 319-385-4532
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Authorized Official
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Title or Position | OWNER
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Name | JEFFERY EDWARD SITAR
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Credential | D.D.S.
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Telephone | 319-385-3795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 7586
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License Number State | IA
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