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General NPI Number Information
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NPI Number | 1932366937
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Entity Type | Individual
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Provider Name | JUAN MANUEL URIBE D.D.S
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Gender | Male
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 132 N MAIN AVE
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City | SIOUX CENTER
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State | IA
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Zip | 51250-1543
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Country | US
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Telephone | 712-722-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 150 BURDICK ST
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City | SALIX
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State | IA
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Zip | 51052-8096
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Country | US
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Telephone | 712-946-7741
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 08565
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License Number State | IA
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