NPI | 1013124056 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID J. BRUSKY President 920-662-1440 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 4498-015) |
Enumeration Date | 2007-05-17 |
Last Update Date | 2009-03-24 |