Dittmer, Mark A
Dittmer, Mark A is an individual health care provider with primary practice located at 51300 Pomerantz Family Pavilion , Iowa City IA 52240. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Dittmer, Mark A can be contacted via phone (319) 356-2743.Contact Information
Primary practice address
51300 Pomerantz Family Pavilion
Iowa City IA 52240
Phone: (319) 356-2743
Fax: (319) 353-6923
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 07141 | Iowa |
Profile Details
| NPI number | 1396720231 |
|---|---|
| LBN Legal business name | Dittmer, Mark A |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 14th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396720231 | NPPES |
| Iowa | MEDICAID | 0248039 |
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