| NPI | 1073794582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE STEMPSKI Director 920-448-7340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WI 2268) |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2007-11-27 |