| NPI | 1912127960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LELAND FOSTER HAWKINS Owner 641-752-3337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 7680) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |