| NPI | 1376558106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE OSTRANDER Manager 608-752-7931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 3949-015) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |