| NPI | 1710139191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW SEAN HAGARTY President 319-351-9723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 8341) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |