| NPI | 1720055015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL J. KOEHL President 715-344-7911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 3599) |
| Enumeration Date | 2006-03-05 |
| Last Update Date | 2020-08-22 |