| NPI | 1578324083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERON GLENN LAYER President 319-671-1233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-07-22 |