| NPI | 1265711659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH ALAN JOHNSON Dentist 641-592-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA #6195) |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2011-08-16 |