| NPI | 1003849100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID T ALLEN Privacy Official 608-833-6112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2011-12-05 |