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General NPI Number Information
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NPI Number | 1437689940
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Entity Type | Organization
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Legal Business Name | MEDI-DENT, INC.
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1050 15TH ST. S.W. SUITE 2
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City | MASON CITY
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State | IA
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Zip | 50401
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Country | US
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Telephone | 641-450-0281
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Fax | 641-450-0284
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Provider Business Mailing Address
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Address Line | 1050 15TH ST SW STE 2
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City | MASON CITY
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State | IA
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Zip | 50401-5677
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Country | US
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Telephone | 641-450-0281
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Fax | 641-450-0284
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Authorized Official
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Title or Position | PARTNER/OWNER
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Name | MR. FRANCIS J CONNELLY
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Credential |
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Telephone | 641-450-0281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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