| NPI | 1730184557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A FITCH President 414-354-9020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WI 5001515-015) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2020-08-22 |