Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 30271 | IA |
NPI | 1124275490 |
---|---|
Provider Name | Dr. Jose David Vela |
First Address | Iowa City, IA 52245-9596 |
Second Address | Iowa City, IA 52242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2008 |
Last Update Date | 19/08/2008 |