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General NPI Number Information
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NPI Number | 1609956234
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Entity Type | Organization
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Legal Business Name | STATE UNIVERSITY OF IOWA
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 322 DENTAL SCIENCE BLDG
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City | IOWA CITY
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State | IA
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Zip | 52242-1001
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Country | US
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Telephone | 319-335-7440
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Fax | 319-335-7451
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Provider Business Mailing Address
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Address Line | 322 DENTAL SCIENCE BLDG
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City | IOWA CITY
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State | IA
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Zip | 52242-1001
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Country | US
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Telephone | 319-335-7440
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Fax | 319-335-7451
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Authorized Official
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Title or Position | ASSOCIATE DEAN FOR FINANCE AND ADMI
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Name | PAULINA JANCZUK
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Credential | MBA, MPH
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Telephone | 319-467-0735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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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 | 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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