| NPI | 1447340815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRY THOMAS GRIMES Owner 319-366-2451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 6480) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |