| NPI | 1053430991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY TOMCHEK SARAUER Office Manager 920-922-7012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 4618-015) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |