| NPI | 1275790735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW A.T. CROCO Owner 319-545-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IA 08174) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-05-21 |