DIAMOND TRAIL DENTAL PC NPI 1164761698

NPI Information

NPI: 1164761698
Provider Name: DIAMOND TRAIL DENTAL PC

Doing Business As: DIAMOND TRAIL DENTAL

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
301 S. 4TH ST.
MONTEZUMA, IA
ZIP 50171
Phone: (641) 623-5100
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DIAMOND TRAIL DENTAL PC is a dental clinic center in Montezuma, IA. DIAMOND TRAIL DENTAL PC NPI is 1164761698. The provider is registered as an organization entity type.
The provider Is Doing Business As Diamond Trail Dental.

The provider's business location address is:

301 S. 4TH ST.
MONTEZUMA, IA
ZIP 50171-031
Phone: (641) 623-5100

The provider's authorized official is Eric Chad Deboef .
The authorized official title is President and has the following contact phone number (641) 673-3008.

The enumeration date for this NPI number is 2/4/2013 and was last updated on 2/4/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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