| NPI | 1972771418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOBIN J. STRUPP Managing Member 262-783-3311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 3573-015) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |