| NPI | 1083881379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS ALBERT MOUNSDON Doctor 641-446-7766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IA 06687) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |