| NPI | 1932420718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD WALTER RASCH Owner 262-956-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 6251-15) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2010-06-16 |