| NPI | 1871643635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL S ZAVADSKY Owner President 608-524-4212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WI 5001095) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-08-22 |