| NPI | 1790058865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JOSEPH OWENS Owner 715-341-5441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5001311) |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2012-02-20 |