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Deforest Dental Services

NPI #1730282344 in Deforest, Wisconsin

Provider Information

NPI Number
1730282344
Entity Type
Organization
Organization Name
Deforest Dental Services
Primary Specialty
Dentist - General Practice
Enumeration Date
Sep 7, 2006
Last Updated
Aug 22, 2020

Practice Location

Address
210 N. MAIN ST.
Address 2
STE 103
City
Deforest
State
Wisconsin
ZIP Code
53532
Phone
(608) 846-3948

Authorized Official

Name
MR. GERALD ROGER CORCORAN, DDS
Title
PRESIDENT
Phone
(608) 846-3948

Specialties & Taxonomy Codes

Specialty
Dentist - General Practice — General Practice

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