| NPI | 1396866026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN BURTON COOK President And Treasurer 608-782-9667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 3279) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |