| NPI | 1154601540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVIEVE POPPE Director Of Operations 608-358-3370 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WI 6795-15) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2014-06-05 |