| NPI | 1871763920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE A. WIHLM Dentist 920-231-0060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 6146) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2016-12-13 |