| NPI | 1831223981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE BRUCE SHOEMAKER President 262-542-0431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 4261) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |