| NPI | 1790032282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL JAMES WINN Dentist 715-723-0287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 6264-015) |
| Additional Taxonomies | 126800000X Dental Assistant |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2012-08-14 |