| NPI | 1831800309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM HAMMERBECK Owner 920-822-8388 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2024-04-23 |