| NPI | 1013092667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY J HATHAWAY Owner 563-323-9331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 07404) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |