| NPI | 1316060833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN EDWIN BROAD General Dentist 319-366-8521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 06477) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2008-07-24 |