| NPI | 1568978856 |
|---|---|
| Doing Business As | FOUR CORNERS FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | GREGORY J MOOS Owner Dentist 715-495-5131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2017-12-21 |