| NPI | 1629186986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN G MARINACCIO President 920-682-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5000669) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2020-08-22 |