Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery | |
Oral and Maxillofacial Surgery |
1223S0112X | 19 | Oral Surgery (Dentist only) |
| NPI Number | 1215071394 |
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| LBN Legal business name | NORTH IOWA ORAL SURGERY AND DENTAL IMPLANT CENTER, LLP | ||||||||
| Authorized official | LYELL HOGG - (OWNER) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 02/20/2007 | ||||||||
| Last updated | 01/04/2018 - About 8 years ago | ||||||||
| Identifiers |
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