| NPI | 1689072217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN JOSEPH BURDS Dentist/Owner 515-244-0329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 08102) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2014-12-13 |
| Last Update Date | 2014-12-22 |