Dewitt Family Dentistry P.C.
Organization Active NPI General Practice Dentistry · De Witt, IA
NPI 1104987833 · NPPES record last updated Jul 22, 2008
Key facts
- NPI
- 1104987833
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 08332 (IA)
- Legal business name
- DEWITT FAMILY DENTISTRY P.C.
- Practice address
- 923 6TH Ave
De Witt, IA 52742-1330 - Phone
- (563) 659-9500
- NPI assigned
- Dec 13, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Traci Paulsen, D.D.S.
- Title
- Owner
- Phone
- (563) 659-9500
Practitioners 5
-
Lauren Daufeldt, DDS
-
Randall A. Hunt, D.D.S.
-
Sarah J. Matkovich, D.D.S.
-
Traci Paulsen, D.D.S.
-
Samantha Wagler, D.D.S.
National Provider Directory
Locations
923 6th Ave
De Witt, IA 52742
Phone (563) 659-9500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 07800 | IA | |
| General Practice Dentistry |
1223G0001X | 06566 | IA | |
| General Practice Dentistry |
1223G0001X | 08332 | IA | Yes |
Addresses
Primary practice location
923 6TH Ave
De Witt, IA 52742-1330
Mailing address
923 6TH Ave
De Witt, IA 52742-1330
Phone (563) 659-9500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0473173 | Medicaid | IA | |
| 0264440 | Medicaid | IA | |
| 0911644 | Medicaid | IA |
Other providers in De Witt, IA
- Cram Chiropractic, PLLC
- Jacob Andrew Cram
- Lauren Daufeldt
- Dewitt Dental Associates, PC
- Dewitt ER PC Services
- Dewitt Family Practice, PLLC
- Dewitt Pharmacy Inc
- Dewitt Pharmacy Inc
- Morgan E Dewitt
- Kristen R Dunne
All providers in De Witt, IA · General Practice Dentistry in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.