| NPI | 1861659963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS ROBERT SHERRADEN Owner 608-221-8787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WI WI 3555) |
| Enumeration Date | 2008-05-18 |
| Last Update Date | 2008-05-18 |