| NPI | 1962553834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J MCNAMARA President 414-425-7710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: WI 2918) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |