| NPI | 1417004177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGHAN K O'BRIEN Practice Owner 715-627-4391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WI 5001261-015) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2016-12-14 |