Organization Name: | CHILDREN'S DENTISTRY OF COUNCIL BLUFFS, P.C. |
NPI Number: | 1033232186 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH ANTHONY QUATTROCCHI (OWNER) |
Mailing Address: | 40 Northcrest Dr Council Bluffs |
State: | IA US |
Postal Code: | 515031622 |
Phone Number: | 7123289605 |
Fax Number: | 7123289608 |
NPI Enumeration Date: | 04/06/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 8243 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |