NPI | 1417075615 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH JAMES SHECKLER President 641-228-2354 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 7045) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2020-08-22 |