| NPI | 1790816817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI OUDERKIRK-BOCK Owner 712-263-5615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 07912) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2025-04-04 |