NPI | 1962534446 |
---|---|
Entity Type | Organization |
Authorized Contact | PETER DAVID LEMON President 515-221-0807 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IA 8032) |
Enumeration Date | 2007-03-11 |
Last Update Date | 2010-07-22 |