| NPI | 1275667149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN D. PETERSON President 608-664-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 3613-015) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |