| NPI | 1861927535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VASSILIS K PANAGOPOULOS Dentist/President 262-717-9104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WI 6265-15) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |