| NPI | 1841411659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KRIGBAUM Owner 715-842-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: WI 4501) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2008-04-20 |