| NPI | 1447390521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BALBIR R BAGGA President 414-744-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 2545) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 4146) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 2545) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |