| NPI | 1417169160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY R KINZEL Vice President 608-833-6545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI wi3347) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2008-06-24 |