| 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 |