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DR. CALDWELL'S DENTAL OFFICE

Dental Care Facilities

Coralville, Iowa

Provider NPI: 1033370374

Organization Information:
Organization Name:  DR. CALDWELL'S DENTAL OFFICE
Organization is not Subpart
Authorized Official:  BENITA H. CALDWELL  DENTIST  319-3513675

Practice Location:
1756 5TH ST  CORALVILLE, IA 52241 US
Tel: 319-351-3675  Fax: 319-351-3675

Business Mailing Address:
1756 5TH ST  CORALVILLE, IA 52241 US
Tel: 319-351-3675  Fax: 319-351-3675

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QD0000XAmbulatory Health Care Facilities
Clinic/Center
Dental
IA7108

Other Provider Identifiers:

IssuerNumberStateType
DELTA DENTAL OF IOWA232058IA01
WELLMARK23205IA01
0232058IA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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