| NPI | 1326343252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS STEVEN WAAGE Pediatric Dentist/Sole Member 515-987-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IA 08555) |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2011-01-25 |