| NPI | 1770911976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVIEVE E POPPE Partner 608-358-3370 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: WI 5001847-15) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: WI 7160-15) |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2013-10-24 |