| NPI | 1861595324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN RAYMOND KANUGH President Dentist 414-645-0217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5266015) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 3800015) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |