| NPI | 1154354249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN J SKIBBA Privacy Officer 608-246-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |