| NPI | 1053447060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOHN RADKE President 414-545-8226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 3977) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |