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Oral Surgery, Dental Specialists

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MICHAEL JAMES KANELLIS DDS MS

Pediatric Dentistry

Iowa City, Iowa

Provider NPI: 1518061209

Provider Information:
 MICHAEL JAMES KANELLIS DDS MS
Gender: M
Not Sole Proprietor

Practice Location:
322 S DENTAL SCIENCE BLDG  IOWA CITY, IA 52242 US
Tel: 319-384-1139  Fax: 319-384-1785

Business Mailing Address:
257 S DENTAL SCIENCE BLDG  IOWA CITY, IA 52242 US
Tel: 319-335-7431  Fax: 319-335-7155

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223P0221XDental Providers
Dentist
Pediatric Dentistry
IA06521

Other Provider Identifiers:

IssuerNumberStateType
1007047IA05
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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