Provider Demographics
NPI:1952789448
Name:DIEHL, URSULA ANNE (DDS)
Entity Type:Individual
Prefix:
First Name:URSULA
Middle Name:ANNE
Last Name:DIEHL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:URSULA
Other - Middle Name:ANNE
Other - Last Name:SWANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1962 1ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5330
Mailing Address - Country:US
Mailing Address - Phone:319-364-2413
Mailing Address - Fax:
Practice Address - Street 1:1962 1ST AVE NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5330
Practice Address - Country:US
Practice Address - Phone:319-364-2413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-093751223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry