| NPI | 1255729281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS VALERI Owner 262-577-5242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 7051-15) |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2014-12-29 |