| NPI | 1609030337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN WADE ANCELL General Dentist 515-226-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 08114IA) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2008-07-11 |