| NPI | 1144300625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE J. BERNA Office Manager 715-848-2435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: WI 2929) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |