| NPI | 1508035445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS THADDEOUS TANG President 262-821-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 3801) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2008-02-25 |