NPI | 1134312242 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK J KNEEPKENS President 414-321-7274 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 2614) |
Enumeration Date | 2007-08-22 |
Last Update Date | 2007-08-22 |