Mikelson, C James

Mikelson, C James is an individual health care provider with primary practice located at 3308 Kimball Ave , Waterloo IA 50702. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mikelson, C James can be contacted via phone (319) 233-6177.

Contact Information

Primary practice address
3308 Kimball Ave Waterloo IA 50702
Phone: (319) 233-6177
Fax: (319) 234-3906
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 05851 Iowa

Profile Details

NPI number 1831101427
LBN Legal business name Mikelson, C James
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831101427 NPPES
Iowa MEDICAID 0120865

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