| NPI | 1235251125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY M PIETZ President 414-281-1881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 5736) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2017-03-24 |