Provider Demographics
NPI:1497510838
Name:IOWA PEDIATRIC DENTAL SURGERY, P.L.L.C.
Entity Type:Organization
Organization Name:IOWA PEDIATRIC DENTAL SURGERY, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-480-4612
Mailing Address - Street 1:1111 JORDAN CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5816
Mailing Address - Country:US
Mailing Address - Phone:515-222-1803
Mailing Address - Fax:515-222-1805
Practice Address - Street 1:1111 JORDAN CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5816
Practice Address - Country:US
Practice Address - Phone:515-222-1803
Practice Address - Fax:515-222-1805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty