| NPI | 1427513902 |
|---|---|
| Doing Business As | EDGEWOOD DENTAL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL LYSONSKI Dr. 262-391-6179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2023-03-07 |