Oak Grove Dental Associates, LLC

NPI #1164549754 in Green Bay, Wisconsin

Provider Information

NPI Number: 1164549754
Entity Type: Organization
Organization Name: Oak Grove Dental Associates, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 26, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1640 MAIN ST
City: Green Bay
State: Wisconsin
ZIP Code: 54302-2639
Phone: (920) 468-6371

Authorized Official

Name: DR. SCOTT ROBERT GREATENS, D.D.S.
Title: MANAGING PARTNER
Phone: (920) 468-6371

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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