| NPI | 1235360975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S THOMAS Owner 319-396-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 6700) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 08112) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2009-07-29 |