| NPI | 1578985529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE ANDERSEN Manager 608-467-8022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5045) |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2014-01-10 |