| NPI | 1841300688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE PATRICK RILEY Dentist Owner 319-331-1716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Additional Taxonomies | 122300000X Dentist (Licence: CO S137) |
| 1223X2210X Dentist Orofacial Pain | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-11-01 |