| NPI | 1265501787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN WALTER SEGALL President 608-222-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: WI 5001279015) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2008-08-18 |