| NPI | 1629280193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CHRISTIAN HANSEN President 319-351-6622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IA 7162) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |