Oak Grove Dental Associates, LLC

NPI #1235665464 in Green Bay, Wisconsin

Provider Information

NPI Number: 1235665464
Entity Type: Organization
Organization Name: Oak Grove Dental Associates, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: May 9, 2017
Last Updated: May 9, 2017

Practice Location

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

Authorized Official

Name: MS. SARA HEINEMEYER
Title: ADMINISTRATIVE ASSISTANT
Phone: (920) 733-4787

Specialties & Taxonomy Codes

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

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