| NPI | 1922244193 |
|---|---|
| Doing Business As | MOUNTAIN DENTAL |
| Entity Type | Organization |
| Authorized Contact | LORI PELKE Professional Services 715-926-5050 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2008-12-18 |