NPI | 1609908219 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES EBNER LUETZOW President 262-554-5468 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 2387) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2020-08-22 |