| NPI | 1972627362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH J. WHITTEMORE Owner 319-232-1354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 07395) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |