| NPI | 1225395304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ROBERT BARDEN President 414-915-4080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WI 5530-015) |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2012-04-13 |