| NPI | 1124101787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES P HAMMER Dentist 641-684-8636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 7799) |
| Additional Taxonomies | 122300000X Dentist |
| 122300000X Dentist (Licence: IA 4841) | |
| 122300000X Dentist (Licence: IA 7691) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |