| NPI | 1215006747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN HERMANSON Orthodontist 641-752-6458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IA 7942) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IA 5771) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2015-09-12 |