| NPI | 1215175146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN MARIE BERK Sr. Director Of Corporate Services 414-225-1568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2024-03-08 |