| NPI | 1982920740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVIEVE E POPPE Director Of Operations 608-358-3370 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5001590-15) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 6297-15) |
| 1223G0001X Dentist, General Practice (Licence: WI 6574-15) | |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2012-12-28 |