| NPI | 1699985754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD S. WALCZAK Dentistry 715-341-8335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 3383) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |