| NPI | 1700105442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE PAIGE WINGROVE Owner 319-233-0803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: IA 08295) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2014-10-20 |