| NPI | 1669684726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ROBERT NORRIS President 715-377-7860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: WI 5100) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |