| NPI | 1952832776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW RASMUSSEN Dentist 920-655-4732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 6884-15) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-23 |