| NPI | 1528015328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALVADOR D ATIENZA President 563-652-4133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 7745) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 8368) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2009-01-05 |