Provider Demographics
NPI:1710047063
Name:PROSTHODONTIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:PROSTHODONTIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:DUNNE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:319-337-7017
Mailing Address - Street 1:180 HOLIDAY RD
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-1175
Mailing Address - Country:US
Mailing Address - Phone:319-337-7017
Mailing Address - Fax:319-337-2679
Practice Address - Street 1:180 HOLIDAY RD
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-1175
Practice Address - Country:US
Practice Address - Phone:319-337-7017
Practice Address - Fax:319-337-2679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty