Individual
DR. CHRISTOPHER MICHAEL MOOTHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1475 BOYSON RD, HIAWATHA, IA 52233-2339
(319) 393-4019
Mailing address
1055 W CHERRY ST, NORTH LIBERTY, IA 52317-9075
(319) 594-7339
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08644
IA
Other
Enumeration date
06/25/2009
Last updated
06/03/2010
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