| NPI | 1053837690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAITLIN JOY HOOGEVEEN Owner 712-441-2807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: IA DDS-09373) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2017-08-15 |