| NPI | 1568522720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD J. TROCHLELL President/Owner 262-786-1270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 5001405) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 50011629) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2014-05-27 |