| NPI | 1285891176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD B STEVENSON President/Owner/Dentist 515-223-1940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IA 7330) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2008-05-19 |