Provider Demographics
NPI:1497912034
Name:LANGWORTHY DENTAL GROUP
Entity Type:Organization
Organization Name:LANGWORTHY DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:563-583-2681
Mailing Address - Street 1:989 LANGWORTHY ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-7368
Mailing Address - Country:US
Mailing Address - Phone:563-583-2681
Mailing Address - Fax:563-583-6303
Practice Address - Street 1:989 LANGWORTHY ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7368
Practice Address - Country:US
Practice Address - Phone:563-583-2681
Practice Address - Fax:563-583-6303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA7034122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty