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NPI Code Detail

MEDICARE: DEMARCO DENTAL PRACTICE,P.C.

MEDICARE: DEMARCO DENTAL PRACTICE,P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist

General Provider Information

NPI Number : 1851643019
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEMARCO DENTAL PRACTICE,P.C.
Provider Business Mailing Address
First Line : 974 73RD ST
Second Line : SUITE 37
City : WINDSOR HEIGHTS
State : IA
Zip : 50324-1024
Country : US
Telephone Number : 515-282-0973
Fax Number : 515-288-5552
Provider Business Practice Location Address
First Line : 974 73RD ST
Second Line : SUITE 37
City : WINDSOR HEIGHTS
State : IA
Zip : 50324-1024
Country : US
Telephone Number : 515-282-0973
Fax Number : 515-288-5552
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. MICHELLE LYNN DODDS
Credential :
Telephone Number : 515-282-0973
Provider Enumeration Date : 10/11/2012
Last Update Date : 10/11/2012

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Directions to “DEMARCO DENTAL PRACTICE,P.C. ” Practice Location

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