| NPI | 1407131618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARCY JAY RINDELAUB Pediatric Dentist 715-808-0460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 6666-015) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |