| 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 |