NPI | 1932376308 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM BENNETT MOORE Owner 641-456-3352 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 06306) |
Enumeration Date | 2008-05-14 |
Last Update Date | 2008-05-14 |