| NPI | 1013038207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MALCOLM MAYHEW Dentist Practice President Owner 920-854-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5002020015) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-07-30 |