| NPI | 1992994339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JOSEPH KNEEPKENS Owner 262-542-6170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WI 2614) |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2008-06-23 |