| NPI | 1417411679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT M VILLWOCK Dentist 920-465-4477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2021-06-28 |