| NPI | 1861547754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICKA TAYLOR Director Of Hr 608-833-4814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5000305) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2015-06-01 |