Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | R-9839 | IA |
N | 208600000X | Surgeon | R-9839 | IA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | DO-05518 | IA |
NPI | 1124468517 |
---|---|
Provider Name | Dr. Dante Caleb-Samuel Dali |
First Address | Mason City, IA 50401-2926 |
Second Address | Mason City, IA 50401-2926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2013 |
Last Update Date | 14/10/2020 |