Delevan Family Dentistry

NPI #1427290147 in Delavan, Wisconsin

Provider Information

NPI Number: 1427290147
Entity Type: Organization
Organization Name: Delevan Family Dentistry
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 26, 2009
Last Updated: Mar 26, 2009

Practice Location

Address: 1624 HOBBS DR
Address 2: SUITE 2
City: Delavan
State: Wisconsin
ZIP Code: 53115-2000
Phone: (262) 740-1010

Authorized Official

Name: GENIE KUBLE
Title: CONTACT OFFICER
Phone: (920) 450-0157

Specialties & Taxonomy Codes

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

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