Provider Demographics
NPI:1376674952
Name:SIERK, DONALD L (DDS, MS, PC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:SIERK
Suffix:
Gender:M
Credentials:DDS, MS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3292
Mailing Address - Country:US
Mailing Address - Phone:563-359-8211
Mailing Address - Fax:563-359-5710
Practice Address - Street 1:1918 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3292
Practice Address - Country:US
Practice Address - Phone:563-359-8211
Practice Address - Fax:563-359-5710
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA58231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics