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General NPI Number Information
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NPI Number | 1871655159
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Entity Type | Organization
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Legal Business Name | DUBUQUE DENTAL ASSOCIATES
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 1890 JOHN F KENNEDY RD
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City | DUBUQUE
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State | IA
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Zip | 52002
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Country | US
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Telephone | 563-556-4234
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Fax | 563-556-0597
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Provider Business Mailing Address
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Address Line | 1890 JOHN F KENNEDY RD
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City | DUBUQUE
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State | IA
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Zip | 52002
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Country | US
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Telephone | 563-556-4234
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Fax | 563-556-0597
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Authorized Official
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Title or Position | DENTIST
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Name | DR. BRETT N KILBURG
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Credential | DDS
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Telephone | 563-556-4234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 05476
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License Number State | IA
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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 | 08420
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 08217
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License Number State | IA
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