| NPI | 1174715098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK J KNEEPKENS President 414-463-5480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 2614) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2011-09-27 |