| NPI | 1114053857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HENRY LEUCK President 515-224-4455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IA 05633) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |