| NPI | 1467747303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDY MANCINI Owner/President 855-527-3848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: WI 6499-015) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2011-06-17 |