| NPI | 1720569783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JOHN GOECKERMANN Owner 414-281-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 5910-15) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2023-08-30 |