Old Oaks Dental LLC
NPI #1093446163 in Pleasant Prairie, Wisconsin
Provider Information
- NPI Number
- 1093446163
- Entity Type
- Organization
- Organization Name
- Old Oaks Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jun 20, 2022
- Last Updated
- Jun 20, 2022
Practice Location
- Address
- 9809 39TH AVE STE 1
- City
- Pleasant Prairie
- State
- Wisconsin
- ZIP Code
- 53158-3733
- Phone
- (715) 573-3868
Authorized Official
- Name
- AARON BUSHONG, DDS
- Title
- OWNER
- Phone
- (715) 573-3868
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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