| NPI | 1134267479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL P. GREMBAN President 715-365-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WI 3195-015) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |