Sparta Dental Center Sc

NPI #1174701676 in Sparta, Wisconsin

Provider Information

NPI Number: 1174701676
Entity Type: Organization
Organization Name: Sparta Dental Center Sc
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Feb 6, 2008
Last Updated: Feb 6, 2008

Practice Location

Address: 3000 RILEY RD
City: Sparta
State: Wisconsin
ZIP Code: 54656-6588
Phone: (608) 269-5282

Authorized Official

Name: JENNIFER L KNOLL, DDS
Title: OWNER
Phone: (608) 269-5282

Specialties & Taxonomy Codes

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

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