| NPI | 1942379805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID B WELLES Chief Operating Officer 715-845-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2023-06-23 |