NPI | 1811005903 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD LEE ZUSSMAN President Of Corp Orthodontist 414-351-1939 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 5001251) |
Enumeration Date | 2006-08-28 |
Last Update Date | 2020-08-22 |