NPI | 1376626325 |
---|---|
Entity Type | Organization |
Authorized Contact | GARY C. NOBLE Vice President 920-435-6894 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 4416) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2020-08-22 |