| NPI | 1922506989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENT NESTMAN Owner 319-331-9935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 9822) |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2018-01-24 |