GREAT RIVER ORAL AND MAXILLOFACIAL SURGERY PC (NPI# 1992799811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992799811 |
| Entity Type | Organization |
| Organization Name | GREAT RIVER ORAL AND MAXILLOFACIAL SURGERY PC |
| Practice Address |
100 Bryant St Dubuque IA 52003-7405 |
| Practice Telephone | 5635571440 |
| Practice Fax Number | 5635577001 |
| Mailing Telephone | 5635571440 |
| Mailing Fax Number | 5635577001 |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | THOMAS P WILLIAMS (PRESIDENT) |
| Authorized Official Telephone | 5635571440 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
Ambulatory Health Care Facilities |
| Street Address |
100 BRYANT ST |
| City | DUBUQUE |
| State | IA |
| Zip Code | 52003-7405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821082744 | Daryl E Bee | Dentist | 100 Bryant St, Dubuque, IA 52003-7405 | 2005-09-07 |
| 1326245796 | Kimberly Victoria Pingel | Dentist | 100 Bryant St, Dubuque, IA 52003-7405 | 2007-06-29 |
| 1942287875 | Thomas J King IIi | Dentist | 100 Bryant St, Dubuque, IA 52003 | 2005-12-30 |
| 1780678466 | Thomas P Williams | Dentist | 100 Bryant St, Dubuque, IA 52003-7405 | 2005-09-08 |
| 1235123936 | Andrew M Dewitt | Dentist | 100 Bryant St, Dubuque, IA 52003-7405 | 2005-09-08 |
| 1124012059 | Michael J Dalton | Dentist | 100 Bryant St, Dubuque, IA 52003-7405 | 2005-09-07 |
| 1922092865 | Paul E Delong | Dentist | 100 Bryant St, Dubuque, IA 52003-7405 | 2005-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839691 | Steven Anthony Link | Pharmacist | 400 S Locust, Dubuque, IA 52003 | 2020-04-05 |
| 1336703057 | Braces By Abbadent, LLC | Dentist | 3430 Dodge St., Suite 19, Dubuque, IA 52003 | 2019-04-29 |
| 1689172751 | Statera LLC | Clinic/Center | 3375 Lake Ridge Drive, Dubuque, IA 52003 | 2018-01-24 |
| 1083962401 | Megan M Gross | Registered Nurse | 3375 Lake Ridge Dr., Dubuque, IA 52003 | 2012-08-15 |
| 1790067320 | Open Arms Home Health Care LLC | Home Health | 3390 Lake Ridge Drive, Dubuque, IA 52003 | 2011-09-09 |
| 1073539375 | Key West Fire and Ems Association | Ambulance | 10640 Lake Eleanor Road, Dubuque, IA 52003 | 2006-07-14 |
| 1124054283 | Jennifer Rebecca Klein | Chiropractor | 2254 Flint Hill Drive, #1, Dubuque, IA 52003 | 2006-06-23 |
| 1780647586 | Dawnelle Marie-vargas Gordon | Nurse Practitioner | 1023 Shady Oaks Dr, Dubuque, IA 52003 | 2006-04-11 |
| 1013960566 | Peter Joseph Szeibel | Psychiatry & Neurology | 1015 Valentine Dr, Dubuque, IA 52003-0212 | 2006-05-18 |
| 1053363077 | Jack Daniel Hinderman | Chiropractor | 998 Fremont Ave, Ste. L1, Dubuque, IA 52003-0300 | 2006-05-17 |
| Find all providers in zip 52003 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811283302 | Legacy Dental, P.C. | Clinic/Center | 4409 Sw 9th St, Des Moines, IA 50315-3909 | 2011-06-22 |
| 1730355033 | Clinton Dental Surgery Center, P.C. | Clinic/Center | 2314 N 2nd St, Clinton, IA 52732-2434 | 2008-05-06 |
| 1336328509 | Ames Oral Surgeons, P.C. | Clinic/Center | 1212 Duff Ave, Ames, IA 50010-5467 | 2007-10-24 |
| 1851453369 | Oral & Maxillofacial Surgery Assoc PC | Clinic/Center | 116 E 11th St, Suite 201, Spencer, IA 51301-4364 | 2006-12-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.