| NPI | 1053312389 |
|---|---|
| Former Legal Business Name | PETER M WILSENS DDS SC |
| Entity Type | Organization |
| Authorized Contact | THOMAS P CASEY Employee 414-321-2720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 3499) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 6783) |
| 122300000X Dentist (Licence: WI 2304) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2019-10-23 |