| NPI | 1942658141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA FAUCHIER President 319-377-4867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 08498) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2016-05-27 |