| NPI | 1982769386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN RAYMNOD GRIEBAHN President 563-323-2571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IA 6943) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2020-08-22 |