| NPI | 1235354481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS RAYMOND ANDERSON President 414-545-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5001336) |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2020-08-22 |