| NPI | 1740379411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA KAY KELCH Owner/President 515-532-3343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IA 7489) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |