| NPI | 1053689554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID T ALLEN Orthodontist 608-833-6112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WI 5181-015) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2011-12-12 |