| NPI | 1629197769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S. LAFRATTA Partner 262-513-5677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WI 5001794-015) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |