| NPI | 1790003416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY WESSEL Director Of Operations 608-241-3110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 4893-015) |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2010-05-05 |