| NPI | 1659744506 |
|---|---|
| Former Legal Business Name | SWAN DENTAL |
| Entity Type | Organization |
| Authorized Contact | WAEL SHAHSHOUH Vice President 414-258-2216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 019029338) |
| Enumeration Date | 2015-11-01 |
| Last Update Date | 2015-11-01 |