| NPI | 1578763090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD R HANNEMAN President 319-545-6251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 8001) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2007-07-23 |