Provider Demographics
NPI:1134853575
Name:WILLOW CREEK FAMILY DENTISTRY
Entity type:Organization
Organization Name:WILLOW CREEK FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KOBI
Authorized Official - Middle Name:
Authorized Official - Last Name:VOSHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-339-4456
Mailing Address - Street 1:2346 MORMON TREK BLVD STE 2600
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4368
Mailing Address - Country:US
Mailing Address - Phone:319-339-4456
Mailing Address - Fax:319-339-4463
Practice Address - Street 1:2346 MORMON TREK BLVD STE 2600
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-4368
Practice Address - Country:US
Practice Address - Phone:319-339-4456
Practice Address - Fax:319-339-4463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental