Provider Demographics
NPI:1821199357
Name:DANIEL L KALER DDS PC
Entity Type:Organization
Organization Name:DANIEL L KALER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:KALER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:712-276-2766
Mailing Address - Street 1:4224 SERGEANT ROAD
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106
Mailing Address - Country:US
Mailing Address - Phone:712-276-2766
Mailing Address - Fax:712-276-1707
Practice Address - Street 1:4224 SERGEANT ROAD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106
Practice Address - Country:US
Practice Address - Phone:712-276-2766
Practice Address - Fax:712-276-1707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA73201223X0400X
NE57091223X0400X
IA76221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0178749Medicaid
NE=========00Medicaid
IA0178749Medicaid