| NPI | 1306923487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS HENRY NADING Periodontist Owner 262-248-8505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: WI 129015) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |