Kohl Dental LLC

NPI #1437641214 in Wausau, Wisconsin

Provider Information

NPI Number: 1437641214
Entity Type: Organization
Organization Name: Kohl Dental LLC
Primary Specialty: Dentist
Enumeration Date: Jun 6, 2018
Last Updated: Jun 6, 2018

Practice Location

Address: 1 CORPORATE DR STE 104
City: Wausau
State: Wisconsin
ZIP Code: 54401-1725
Phone: (715) 845-9297

Authorized Official

Name: OLGA GRENOVA
Title: DIR OF ACCOUNTING
Phone: (608) 833-2213

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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