| NPI | 1275708117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J KREIFELS President 712-243-3275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IA 6755) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |