| NPI | 1639228497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE JAMES BARRETTE President 715-732-1332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 1594G) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |