| NPI | 1457484966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL K WOOD President 715-423-5950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 3031) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |