| NPI | 1205976776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT G QUIRT Owner 715-355-5570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 5001188) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 5987015) |
| 122300000X Dentist (Licence: WI 5502015) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |