| NPI | 1275618886 |
|---|---|
| Doing Business As | PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | VINCENT W. MANCUSO President 515-223-1298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2010-07-12 |