| NPI | 1700110574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE E KONZE Office Administrator 608-372-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WI 3857) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2014-03-13 |