| Community Health Center Of Fort Dodge Dental Clinic | |
|
330 Avenue M Fort Dodge IA 50501-5739 | |
| (515) 576-6500 | |
| (515) 576-1951 |
| Full Name | Community Health Center Of Fort Dodge Dental Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 330 Avenue M, Fort Dodge, Iowa |
| Authorized Official Name and Position | Kathy J Wilkes (CEO) |
| Authorized Official Contact | 5155766500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Center Of Fort Dodge Dental Clinic 126 N 10th St Fort Dodge IA 50501-3915 Ph: (515) 576-6500 | Community Health Center Of Fort Dodge Dental Clinic 330 Avenue M Fort Dodge IA 50501-5739 Ph: (515) 576-6500 |
| NPI Number | 1508030347 |
|---|---|
| Provider Enumeration Date | 04/14/2008 |
| Last Update Date | 09/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508030347 | NPI | - | NPPES |
| 0490383 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Iowa) | Primary |
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