| NPI | 1508033903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN BLAKE HAMPTON Dentist 515-232-2007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 8068) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2008-05-14 |