| NPI | 1457404741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA JILL FOUST Owner 515-965-0230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IA 08106) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |