| NPI | 1265813521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LAWSON Owner 515-278-4366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 08512) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2024-04-03 |