| NPI | 1992049811 |
|---|---|
| Doing Business As | CHILDREN'S DENTAL CENTER OF SE IOWA |
| Entity Type | Organization |
| Authorized Contact | MICHAEL STEVEN MATHEWS President 319-385-7427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA 8053) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 8186) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |