| NPI | 1063723138 |
|---|---|
| Doing Business As | FOND DU LAC HUMAN SERVICES DIVISION DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | KAREN R DIVER Chairwoman 218-879-4593 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2010-06-23 |