| NPI | 1750747739 |
|---|---|
| Doing Business As | THE COUNTRY DENTIST |
| Entity Type | Organization |
| Authorized Contact | ANDREW T FABIAN Manager 608-712-6320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2016-01-07 |