Provider Demographics
NPI:1346022068
Name:CHILDRENS DENTAL SURGERY ASSOCIATES PLC
Entity Type:Organization
Organization Name:CHILDRENS DENTAL SURGERY ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:BARNARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:515-776-1136
Mailing Address - Street 1:1551 SE 3RD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-8803
Mailing Address - Country:US
Mailing Address - Phone:515-776-1136
Mailing Address - Fax:515-864-0507
Practice Address - Street 1:1551 SE 3RD ST STE 100
Practice Address - Street 2:
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-8803
Practice Address - Country:US
Practice Address - Phone:515-776-1136
Practice Address - Fax:515-864-0507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty