| NPI | 1609080597 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ANN L CONNORS Owner 319-337-7797  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 7186)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 08200)  | 
| Enumeration Date | 2007-05-09 | 
| Last Update Date | 2020-08-22 |