Provider Demographics
NPI:1952083065
Name:MADISON COUNTY DENTAL PARTNERS LLP
Entity Type:Organization
Organization Name:MADISON COUNTY DENTAL PARTNERS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-462-5755
Mailing Address - Street 1:301 WAMBOLD DR
Mailing Address - Street 2:
Mailing Address - City:WINTERSET
Mailing Address - State:IA
Mailing Address - Zip Code:50273-8029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 WAMBOLD DR
Practice Address - Street 2:
Practice Address - City:WINTERSET
Practice Address - State:IA
Practice Address - Zip Code:50273-8029
Practice Address - Country:US
Practice Address - Phone:515-462-5755
Practice Address - Fax:515-462-5861
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MADISON COUNTY DENTAL PARTNERS LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty