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General NPI Number Information
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NPI Number | 1952614794
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Entity Type | Organization
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Legal Business Name | REBECCA J METZGER DDS LLC
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Dates
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Enumeration Date | 07/21/2010
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 1015 DUFF AVE
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City | AMES
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State | IA
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Zip | 50010-5733
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Country | US
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Telephone | 515-252-4236
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 DUFF AVE
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City | AMES
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State | IA
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Zip | 50010-5733
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Country | US
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Telephone | 515-252-4236
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. REBECCA J METZGER
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Credential | DDS
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Telephone | 262-617-9984
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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 | 08619
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License Number State | IA
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