NPI | 1679132815 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT TRETTIN President 414-357-2040 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223P0106X Dentist Oral and Maxillofacial Pathology |
Additional Taxonomies | 1223P0700X Dentist Prosthodontics |
122300000X Dentist | |
Enumeration Date | 2019-06-11 |
Last Update Date | 2019-06-11 |