Provider Demographics
NPI:1053496760
Name:DENTAL TOUCH ASSOCIATES PC
Entity Type:Organization
Organization Name:DENTAL TOUCH ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BLAINE
Authorized Official - Middle Name:WRIGHT
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-373-5082
Mailing Address - Street 1:5945 COUNCIL ST NE # B
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5858
Mailing Address - Country:US
Mailing Address - Phone:319-373-5082
Mailing Address - Fax:319-373-7083
Practice Address - Street 1:5945 COUNCIL ST NE # B
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5858
Practice Address - Country:US
Practice Address - Phone:319-373-5082
Practice Address - Fax:319-373-7083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA77951223G0001X
IA73931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2130047Medicaid
IA3283143Medicaid
IA0748509Medicaid