Organization Name: | CEDAR VALLEY PEDIATRIC DENTISTRY, PC |
NPI Number: | 1194050286 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KELLEY RUEHS (PRESIDENT) |
Mailing Address: | 1301 W 1st St Cedar Falls |
State: | IA US |
Postal Code: | 506132113 |
Phone Number: | 3192774600 |
Fax Number: | 3192665270 |
NPI Enumeration Date: | 10/07/2009 |
NPI Last Update Date: | 10/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 07938 |
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. |