| NPI | 1326011578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L GROVE Dentist Owner 515-986-4001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 8358) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 6772) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2020-08-22 |