| NPI | 1831545763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY L FRADY Dentist 414-529-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 6219) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-11 |