MEDICARE: FRANKLIN PLAZA FAMILY DENTISTRY, 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
1	1223G0001X	General Practice Dentistry	7581	IA

General Provider Information

NPI Number	:	1982871208
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANKLIN PLAZA FAMILY DENTISTRY, P.C.

Provider Business Mailing Address
First Line	:	4954 FRANKLIN AVE
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50310-1901
Country	:	US
Telephone Number	:	515-277-0222
Fax Number	:	515-277-3171

Provider Business Practice Location Address
First Line	:	4954 FRANKLIN AVE
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50310-1901
Country	:	US
Telephone Number	:	515-277-0222
Fax Number	:	515-277-3171

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN CURTIS MCCARTNEY
Credential	:	D.D.S.
Telephone Number	:	515-277-0222

Provider Enumeration Date	:	05/15/2008
Last Update Date	:	05/15/2008

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