| NPI | 1669518213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS R HENSCHEL President 262-796-1312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5863) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 3324) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |