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Mississippi Valley Oral & Maxillofacial Surgery PC

Dentist, Oral and Maxillofacial Surgery in Davenport, IA. Organization (NPI-2).

NPI number1144490707
StatusActive
Last updated in NPPESMar 11, 2008

Details

NPI
1144490707
Entity type
Organization (NPI-2)
Legal business name
Mississippi Valley Oral & Maxillofacial Surgery PC
Organization subpart
No
Enumeration date
Mar 10, 2008
Last updated
Mar 11, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223S0112X Dentist, Oral and Maxillofacial Surgery7637IAYes
1223S0112X Dentist, Oral and Maxillofacial Surgery7766IA
1223S0112X Dentist, Oral and Maxillofacial Surgery7839IA

Practice location

2305 E 52nd St
Suite 1
Davenport, IA 52807-2762

Phone 563-355-9424 · Fax 563-355-0180

Mailing address

2305 E 52nd St
Suite 1
Davenport, IA 52807-2762

Phone 563-355-9424 · Fax 563-355-0180

Authorized official

David A Anderson
Owner/Doctor
5633559424

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Other Oral and Maxillofacial Surgery (Dentist) providers in Davenport, IA

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