| NPI | 1114210481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT C BRUCKNER Owner/Dentist 608-231-2863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WI 5001006015) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2011-05-19 |