| NPI | 1255682183 |
|---|---|
| Other Name | BAD RIVER DENTAL OFFICE |
| Entity Type | Organization |
| Authorized Contact | DEBRA ANN TUTOR Clinic Administrator 715-682-7133 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2012-10-02 |