| NPI | 1972550234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY ANDREWS Office Manager 414-257-1161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2018-06-05 |