| NPI | 1487025391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ROBERT LUNDSTROM Owner/Partner 563-583-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IA DDS-09070) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IA DDS-08953) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2015-10-19 |