| NPI | 1568524825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT C KNUTSON Owner 608-222-3403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 1537-015) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |