Provider Demographics
NPI:1760585350
Name:DENTAL ASSOCIATES OF DECORAH PC
Entity Type:Organization
Organization Name:DENTAL ASSOCIATES OF DECORAH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:KURTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-568-3983
Mailing Address - Street 1:501 SANFORD ST
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101
Mailing Address - Country:US
Mailing Address - Phone:563-382-2441
Mailing Address - Fax:563-382-6048
Practice Address - Street 1:501 SANFORD ST
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101
Practice Address - Country:US
Practice Address - Phone:563-382-2441
Practice Address - Fax:563-382-6048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty