| NPI | 1275786527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI PELKE Professional Services COO Rdinator 715-926-5050 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2008-10-30 |