| NPI | 1780790295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN GAPSON Dentist President 414-271-1770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI WI3500015) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 5000468015) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-08-22 |