NPI | 1043403140 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK J KNEEPKENS President 414-671-5720 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 2614) |
Enumeration Date | 2007-08-22 |
Last Update Date | 2008-06-17 |