| NPI | 1366188534 |
|---|---|
| Doing Business As | DENTISTRY ON VINE |
| Entity Type | Organization |
| Authorized Contact | ZACHARY C WALGENBACH Dentist 715-386-2515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2022-05-10 |