| NPI | 1578697058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLIVER LEE WILLHAM Orthodontist Owner 515-285-6134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IA 7331) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2012-04-11 |