| NPI | 1922095678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS EDWARD RAIMANN Owner 414-425-1510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 2476) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2020-08-22 |