| NPI | 1235146986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES RICHARD MAURIN President / Dentist 414-545-5380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5001638-015) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2020-08-22 |