| NPI | 1861106700 |
|---|---|
| Doing Business As | SOUTH DES MOINES DENTAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | KYLE J CONNOLLY Owner Dentist 515-285-9962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-01-05 |