| NPI | 1265285506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE MARQUARDT Practice Manager 715-365-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2024-04-08 |