| NPI | 1245240357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN DALLMAN Business Administrator 608-837-7394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |