| NPI | 1437533569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN ROBERT PETERSON Dentist 319-331-6351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IA 08702) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2015-07-18 |