| NPI | 1316114580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN BLAKE EVANS Dentist 563-264-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IA 07985) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |