| 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 |