| NPI | 1194926527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES E MONTOURE President Of Corp 920-499-3721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2008-07-25 |