| NPI | 1881842672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | E. LYNN GOETSCH Clinic Supervisor 608-258-2470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2008-09-04 |