| NPI | 1194066167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLANE R CHRISTMAN Owner 715-726-1060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 4080) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: WI 6466) |
| Enumeration Date | 2013-03-15 |
| Last Update Date | 2013-03-15 |