D'Agostino, Bruce Anthony

D'Agostino, Bruce Anthony is an sole proprietor health care provider with primary practice located at 402 W Platt St , Maquoketa IA 52060-2161. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. D'Agostino, Bruce Anthony can be contacted via phone (563) 652-3811.

Contact Information

Primary practice address
402 W Platt St Maquoketa IA 52060-2161
Phone: (563) 652-3811
Fax: (563) 652-3187
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6471 Iowa

Profile Details

NPI number 1063413839
LBN Legal business name D'Agostino, Bruce Anthony
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 3rd, 2005
Last updated Sep 19th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063413839 NPPES
Iowa MEDICAID 1164376

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