| NPI | 1861552614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA LYNN BERRYHILL President 563-927-3612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 7796) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |