Provider Demographics
NPI:1104010552
Name:METZGER, REBECCA JO (DDS)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JO
Last Name:METZGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 DUFF AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5733
Mailing Address - Country:US
Mailing Address - Phone:515-232-4236
Mailing Address - Fax:
Practice Address - Street 1:1015 DUFF AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5733
Practice Address - Country:US
Practice Address - Phone:515-232-4236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA08619122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist