| NPI | 1609848878 |
|---|---|
| Other Name | BROADLAWNS MEDICAL CENTER DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | VINCENT J MANDRACCHIA Chief Medical Officer 515-282-2562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 07724) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2020-08-22 |