Provider Demographics
NPI:1831274935
Name:SIOUXLAND DENTAL HEALTH
Entity type:Organization
Organization Name:SIOUXLAND DENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MEIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-252-3440
Mailing Address - Street 1:2114 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-3847
Mailing Address - Country:US
Mailing Address - Phone:712-252-3440
Mailing Address - Fax:
Practice Address - Street 1:2114 PIERCE ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3847
Practice Address - Country:US
Practice Address - Phone:712-252-3440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty