| NPI | 1356535033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA CALDER Financial Coordinator 920-236-1681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 5001199) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2007-09-05 |