Provider Demographics
NPI:1659198000
Name:DENVER FAMILY DENTAL, PLLC
Entity type:Organization
Organization Name:DENVER FAMILY DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LETA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHMIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-984-6191
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:IA
Mailing Address - Zip Code:50622-0580
Mailing Address - Country:US
Mailing Address - Phone:319-984-6191
Mailing Address - Fax:319-984-6033
Practice Address - Street 1:131 TOWER ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:IA
Practice Address - Zip Code:50622-2201
Practice Address - Country:US
Practice Address - Phone:319-984-6191
Practice Address - Fax:319-984-6033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice