| NPI | 1225553753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKISHA ARIF-HOLMES Dentist/Owner 414-259-0665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WI 6448-15) |
| Enumeration Date | 2017-08-05 |
| Last Update Date | 2017-08-05 |