Provider Demographics
NPI:1982938080
Name:FAMILY DENTAL CARE ASSOCIATES PLC
Entity Type:Organization
Organization Name:FAMILY DENTAL CARE ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HAGANMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:319-321-0251
Mailing Address - Street 1:1000 42ND ST SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-3987
Mailing Address - Country:US
Mailing Address - Phone:319-362-0043
Mailing Address - Fax:319-362-1018
Practice Address - Street 1:1000 42ND ST SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-3987
Practice Address - Country:US
Practice Address - Phone:319-362-0043
Practice Address - Fax:319-362-1018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA69091223G0001X
IA81461223G0001X
IA074461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty