NPI | 1063557643 |
---|---|
Entity Type | Organization |
Authorized Contact | GREGORY C. BRANDT President 515-964-1490 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 6962) |
Enumeration Date | 2007-02-21 |
Last Update Date | 2007-09-20 |