| NPI | 1609846583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA GAIL WEIRICH Insurance Coordinator 515-327-1647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: IA 06447) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2008-05-30 |