Chippewa Dental, LLC

NPI #1699288555 in Chippewa Falls, Wisconsin

Provider Information

NPI Number: 1699288555
Entity Type: Organization
Organization Name: Chippewa Dental, LLC
Primary Specialty: Dentist
Enumeration Date: Nov 14, 2017
Last Updated: Nov 14, 2017

Practice Location

Address: 405 W PRAIRIE VIEW RD
City: Chippewa Falls
State: Wisconsin
ZIP Code: 54729-3389
Phone: (715) 723-7175

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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