| NPI | 1679800239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN OSTERTAG Owner 715-255-5051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 3726-015) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2009-11-03 |