| NPI | 1750452389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES RICHARDT NASS Owner 920-892-2117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 2430-015) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-08-22 |