| NPI | 1457697229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVIEVE POPPE Partner 608-358-3370 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 2334-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 2485-15) |
| Enumeration Date | 2012-12-21 |
| Last Update Date | 2014-06-04 |