Children'S Dentistry of Council Bluffs, P.C.

Organization Active NPI Pediatric Dentistry · Council Bluffs, IA

NPI 1033232186 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1033232186
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Dentistry 1223P0221X
License
8243 (IA)
Legal business name
CHILDREN'S DENTISTRY OF COUNCIL BLUFFS, P.C.
Practice address
40 Northcrest Dr
Council Bluffs, IA 51503-1622
Phone
(712) 328-9605
Fax
(712) 328-9608
NPI assigned
Apr 6, 2007
Organization subpart
No

Authorized official

Name
Dr. Joseph Anthony Quattrocchi Jr., D.D.S.
Title
Owner
Phone
(712) 328-9605

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

40 Northcrest Dr
Council Bluffs, IA 51503
Phone (712) 328-9605

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223P0221X 8243 IA Yes

Addresses

Primary practice location

40 Northcrest Dr
Council Bluffs, IA 51503-1622

Mailing address

40 Northcrest Dr
Council Bluffs, IA 51503-1622
Phone (712) 328-9605

Other identifiers

IdentifierTypeStateIssuer
0463612MedicaidIA
8243OtherIADENTAL LICENSE NUMBER

Other providers in Council Bluffs, IA

All providers in Council Bluffs, IA · Pediatric Dentistry in Iowa

Sources for this page

Verify at the official NPI Registry.