NPI | 1730628330 |
---|---|
Entity Type | Organization |
Authorized Contact | JAY L MACKMAN Owner Director 414-476-9400 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
Enumeration Date | 2017-02-15 |
Last Update Date | 2017-02-15 |