| NPI | 1669659108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DAVID MARKHAM Owner 712-243-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IA 6473) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-01-30 |