| NPI | 1871566257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY WILLIAM HUFF President 262-654-2261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: WI 5000910015) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2020-08-22 |