| NPI | 1063739589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WILLIAM STILP President 715-845-4511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 500212) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2010-04-23 |