Provider Demographics
NPI:1235306408
Name:JAMES J. CAHILL, D.D.S., P.C.
Entity Type:Organization
Organization Name:JAMES J. CAHILL, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CAHILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-232-6804
Mailing Address - Street 1:3308 KIMBALL AVE
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5758
Mailing Address - Country:US
Mailing Address - Phone:319-232-6804
Mailing Address - Fax:319-232-8396
Practice Address - Street 1:3308 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5758
Practice Address - Country:US
Practice Address - Phone:319-232-6804
Practice Address - Fax:319-232-8396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0128454Medicaid