| NPI | 1255447652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN J KRISTO Owner 715-835-5182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 3752) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-08-22 |