| NPI | 1730421850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE FOX Registered Dental Hygienist 262-620-6997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: WI 10253-16) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2013-03-27 |