Provider Demographics
NPI:1376103390
Name:CEDAR VALLEY DENTAL ASSOCIATES PC
Entity Type:Organization
Organization Name:CEDAR VALLEY DENTAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-266-7559
Mailing Address - Street 1:3722 CEDAR HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-6207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:808 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:IA
Practice Address - Zip Code:50665
Practice Address - Country:US
Practice Address - Phone:319-224-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CEDAR VALLEY DENTAL ASSOCIATES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty