NPI | 1144617721 |
---|---|
Entity Type | Organization |
Authorized Contact | AMY N WILKEN-HEYING Owner 319-396-3596 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IA DDS-08160) |
Enumeration Date | 2015-04-21 |
Last Update Date | 2015-04-21 |