Provider Demographics
NPI:1518024561
Name:NORTH, GEORGE F (DDS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:F
Last Name:NORTH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:ALLISON
Mailing Address - State:IA
Mailing Address - Zip Code:50602-0367
Mailing Address - Country:US
Mailing Address - Phone:319-267-2739
Mailing Address - Fax:319-267-2305
Practice Address - Street 1:511 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:ALLISON
Practice Address - State:IA
Practice Address - Zip Code:50602-0367
Practice Address - Country:US
Practice Address - Phone:319-267-2739
Practice Address - Fax:319-267-2305
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA50811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0109090Medicaid