| NPI | 1528469855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA OLEJNICZAK President/Owner 262-377-8950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 7185) |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2014-09-05 |