| NPI | 1215889936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA E GOODELL Owner/Pediatric Dentist 262-310-1819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2026-02-13 |
| Last Update Date | 2026-02-13 |