| NPI | 1871815035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANN MCCONNELL President 920-968-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 3704) |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2010-02-15 |