| NPI | 1104999796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY JOSEPH PHILLIPS Orthodontist 608-271-9293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 4603) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2014-12-05 |