| NPI | 1558528935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JAMES POLKING Owner 641-424-9398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA IA 6422) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2012-07-17 |