NPI | 1811474927 |
---|---|
Entity Type | Organization |
Authorized Contact | KIMBERLY M REYES Owner 515-243-4616 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 09492) |
Enumeration Date | 2018-07-20 |
Last Update Date | 2018-07-20 |