Provider Demographics
NPI:1588784888
Name:WINSLOW, MAUREEN SUZANNE (DDS)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:SUZANNE
Last Name:WINSLOW
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 72ND PL
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-2415
Mailing Address - Country:US
Mailing Address - Phone:515-256-9000
Mailing Address - Fax:515-256-9018
Practice Address - Street 1:1101 CHATHAM AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:IA
Practice Address - Zip Code:50211-9658
Practice Address - Country:US
Practice Address - Phone:515-256-9000
Practice Address - Fax:515-256-9018
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA83501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice