Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 06391 | IA |
NPI | 1013048966 |
---|---|
Provider Name | Dr. Dennis K Langwith |
First Address | Johnston, IA 50131-2240 |
Second Address | Johnston, IA 50131-2240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 08/07/2007 |