NPI | 1922355684 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL R WESTMAN Owner 262-994-4229 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WI 5228015) |
Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WI 5228015) |
Enumeration Date | 2012-08-12 |
Last Update Date | 2012-08-12 |