| NPI | 1598145690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN E BRUMMER President 319-266-7559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IA 08758) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: IA 6208) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2015-06-03 |