| NPI | 1215034889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW CHARLES HARTWIG Owner 319-338-5484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2018-08-30 |