| NPI | 1396920435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS HANSEN Dentist 319-266-1433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 08107) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-01-08 |