| NPI | 1609942580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PAUL CHRISTIAN Dentist Owner 920-426-4540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 4839) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 4081) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2011-06-22 |