| NPI | 1578957411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY K KARKOW Owner 262-232-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: WI 455015) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2015-03-27 |