| NPI | 1942455845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN D LANGEBERG President/Owner 262-242-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 2294) |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2013-01-18 |