| NPI | 1093868523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN D LANGEBERG Vice President 262-242-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 2294) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 0776G) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2008-11-12 |