| NPI | 1417022096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL ANDREW ALBERTSON Dentist 712-527-3144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-08-22 |