NPI | 1790188852 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES TOMASSETTI President 920-738-7600 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 5699) |
Enumeration Date | 2014-10-03 |
Last Update Date | 2014-10-03 |