| NPI | 1982738688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A SHAVLIK Dentist 920-437-8017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 4569-015) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2008-06-13 |