| NPI | 1609493188 |
|---|---|
| Doing Business As | WILLOW DENTAL |
| Entity Type | Organization |
| Authorized Contact | NICHOLAS DWAN General Dentist 262-505-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2020-06-30 |