| NPI | 1811283302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY WAYNE PURK Owner 515-285-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: IA 7566) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2011-11-03 |