| NPI | 1891869699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA L BOTT Owner President 414-764-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 3740) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |