NPI | 1134265606 |
---|---|
Entity Type | Organization |
Authorized Contact | LAKS JAGNANDANDDS Owner 515-964-8350 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 6278) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2020-08-22 |