Cgr Dental, Sc

NPI #1003171281 in Madison, Wisconsin

Provider Information

NPI Number: 1003171281
Entity Type: Organization
Organization Name: Cgr Dental, Sc
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Jul 12, 2012
Last Updated: Jul 12, 2012

Practice Location

Address: 4706 COTTAGE GROVE RD
Address 2: STE. 400
City: Madison
State: Wisconsin
ZIP Code: 53716-1323
Phone: (608) 268-1700

Authorized Official

Name: EDWARD STEPANENKOV
Title: PRESIDENT
Phone: (608) 335-2030

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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