| NPI | 1235140013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK R. BOECHE Owner/ President 608-754-5768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 3112) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2008-06-27 |