| NPI | 1578856225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS E KIELMA Owner 414-649-3510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5001656) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 5003) |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-05-26 |