| NPI | 1508180464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE NORENE HENNESSEY Owner 319-266-1906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 07647) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2010-03-22 |