NPI | 1518266998 |
---|---|
Entity Type | Organization |
Authorized Contact | SCOTT BAUER Director Of PFS De PT 414-808-3020 |
Organization Subpart ? | No |
Primary Taxonomy | 1223E0200X Dentist Endodontics |
Additional Taxonomies | 1223G0001X Dentist General Practice |
1223P0221X Dentist Pediatric Dentistry | |
1223P0300X Dentist Periodontics | |
1223P0700X Dentist Prosthodontics | |
1223S0112X Dentist Oral and Maxillofacial Surgery | |
1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
Enumeration Date | 2011-03-24 |
Last Update Date | 2022-11-15 |