Park View Dental Assoc PC
Organization Active NPI Dentist · Eldridge, IA
NPI 1114071677 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1114071677
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- IA06190 (IA)
- Legal business name
- PARK VIEW DENTAL ASSOC PC
- Practice address
- 5 A Lincoln Ave
Eldridge, IA 52748-9699 - Phone
- (563) 285-8566
- Fax
- (563) 285-8567
- NPI assigned
- Jan 22, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Connie Joan Shaw, DDS
- Title
- President
- Phone
- (563) 285-8566
Practitioners 1
-
Connie J. Shaw, D.D.S.
National Provider Directory
Locations
5 Lincoln Ave
Ste A
Eldridge, IA 52748
Phone (563) 285-8566
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | IA06190 | IA | Yes |
Addresses
Primary practice location
5 A Lincoln Ave
Eldridge, IA 52748-9699
Mailing address
5 A Lincoln Ave
Eldridge, IA 52748-9699
Phone (563) 285-8566
Other providers in Eldridge, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.