Jackson Town & Country Dental LLC

NPI #1790399780 in Jackson, Wisconsin

Provider Information

NPI Number: 1790399780
Entity Type: Organization
Organization Name: Jackson Town & Country Dental LLC
Primary Specialty: Dentist
Enumeration Date: Sep 7, 2020
Last Updated: Sep 7, 2020

Practice Location

Address: N168 W20566 MAIN ST
City: Jackson
State: Wisconsin
ZIP Code: 53037
Phone: (262) 444-0600

Authorized Official

Name: MITCH WEILAND
Title: SENIOR ACCOUNTANT
Phone: (608) 343-0818

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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