| NPI | 1366609364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON LINCOLN HARDINGER Owner 641-423-6172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IA 6432) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2008-05-19 |