| NPI | 1568629947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE ALAN HARRIS Owner/Dentist 641-342-6541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IA 06275) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2008-05-22 |