Provider Demographics
NPI:1417108580
Name:APPLEWHITE DENTAL IOWA PC
Entity Type:Organization
Organization Name:APPLEWHITE DENTAL IOWA PC
Other - Org Name:APPLEWHITE DENTAL PARTNERS IL PC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:563-582-1448
Mailing Address - Street 1:40 MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-7634
Mailing Address - Country:US
Mailing Address - Phone:563-582-1448
Mailing Address - Fax:563-556-1326
Practice Address - Street 1:40 MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001
Practice Address - Country:US
Practice Address - Phone:563-582-1448
Practice Address - Fax:563-556-1326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1223E0200X, 1223P0221X
IA75641223G0001X
IA71011223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty