| NPI | 1861728339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDAL L VALENTA President 715-735-5626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5537) |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2009-11-01 |