| NPI | 1821131210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG JAMES FORSBERG President 608-786-1632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 2948) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2010-08-02 |