| NPI | 1588117998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS A. ROMERO CEO/Member 715-623-7221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WI 1000986-15) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2016-08-02 |