| NPI | 1174094924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BLOCH Owner 715-490-8665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2022-01-10 |