| NPI | 1164080099 |
|---|---|
| Other Name | GL LA CROSSE DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | KARI B ADANK Cco 608-775-8025 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2021-08-06 |