| NPI | 1669738902 |
|---|---|
| Doing Business As | SOUTHSIDE DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | TAE BARTO President 515-783-5564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 08632) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-10 |