| NPI | 1215091830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS WILLIAM HANNEMAN President 319-472-5209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 6311) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |