| NPI | 1730118928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL H BURNS Owner/Dentist/Vice President 262-542-4827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2024-06-20 |