NPI 1053760306

Joseph James Formanek, DDS

Practitioner General Practice Dentistry Ankeny, IA

Practice location

Address: 2409 SE Delaware Ave, Ankeny, IA 50021-4553
Phone: (515) 650-9390

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence DDS-09289 (IA)

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Registry record

NPI: 1053760306
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Jun 2016
Record last updated: 17 Jun 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.