Provider Demographics
NPI:1992982177
Name:LEMARS DENTAL CENTER
Entity type:Organization
Organization Name:LEMARS DENTAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:RHEA-BOHNENKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:712-786-2286
Mailing Address - Street 1:1311 HAWKEYE AVE SW
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-1866
Mailing Address - Country:US
Mailing Address - Phone:712-546-5183
Mailing Address - Fax:712-546-9278
Practice Address - Street 1:1311 HAWKEYE AVE SW
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-1866
Practice Address - Country:US
Practice Address - Phone:712-546-5183
Practice Address - Fax:712-546-9278
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEMARS DENTAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-30
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA074331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty