| NPI | 1588798912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JAMES MCREATH President 608-356-2151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 4280015) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |