| NPI | 1285777227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY R LANG Vice President 920-731-1213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5069015) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |