| NPI | 1265699607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH G DEMRO President 641-424-3375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IA 6968) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2008-05-22 |