| NPI | 1205804663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL J HASH Owner 715-842-4649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 4970) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 5059) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 3444) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 5001555) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2020-08-22 |