| NPI | 1386850790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD DAVID PIONEK CEO 1920-437-8116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 5000338-15) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |