| NPI | 1417330945 |
|---|---|
| Doing Business As | WESTSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | WILLIAM C MAUTHE Owner 920-921-1244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |