NPI | 1508540238 |
---|---|
Entity Type | Organization |
Authorized Contact | ALEXIA DEWANE Owner 920-254-5310 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Additional Taxonomies | 122300000X Dentist |
Enumeration Date | 2023-06-13 |
Last Update Date | 2023-06-13 |