| NPI | 1871655159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT N KILBURG Dentist 563-556-4234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 08217) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 05476) |
| 1223G0001X Dentist, General Practice (Licence: IA 08420) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2013-08-14 |