| NPI | 1083881270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE ANTHONY D'AGOSTINO President 563-652-3811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 6471) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |