is a Dental in Monona, Wisconsin. practices all healthcare services and medical treatments related to Dental. The NPI Number for is 1861659963. The last update date is .
's current location address is 100 River Pl, Monona, Wisconsin. You can contact this provider via phone number 6082218787 and fax number 6084419157. The mailing address for is 100 River Pl, Monona, Wisconsin. To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | 100 River Pl, Monona, Wisconsin |
Phone Number | 6082218787 |
Fax Number | 6084419157 |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1861659963 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 100 River Pl |
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City | Monona |
State | Wisconsin (WI) |
Post Code | 537164041 |
Phone Number | 6082218787 |
Fax Number | 6084419157 |
Provider's Primary Taxonomy Detail
Speciality | Dental |
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Taxonomy | 261Qd0000X |
Licence No | WI 3555 |
Definition: Provides general and specialized dental care and oral surgery. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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33482200 | WI | -- |
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