| NPI | 1174544357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT WALLACE HURLEY Dentist/Owner 712-347-6151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 6855) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 8132) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2011-06-03 |