| NPI | 1144239724 |
|---|---|
| Other Name | PARK AVENUE DENTAL |
| Entity Type | Organization |
| Authorized Contact | PATRICK MICHAEL SNYDER President 715-723-0366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5001705) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2008-06-12 |