| NPI | 1487284287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEIVA ANN DELANEY Senior Operations Manager 515-313-5776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2020-01-21 |