| NPI | 1912165176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD LEE RODGERS Owner/Periodontist 712-255-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IA 6596) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2008-05-23 |