| NPI | 1124573902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA SAWYER Director Of Operations 715-835-5182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 1001026) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2016-08-22 |