| NPI | 1841258837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MARK MATHISON Owner/Dds 218-233-4267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 9145) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2014-06-26 |