Oshkosh Family Dental 2, LLC

NPI #1831752096 in Oshkosh, Wisconsin

Provider Information

NPI Number: 1831752096
Entity Type: Organization
Organization Name: Oshkosh Family Dental 2, LLC
Primary Specialty: Dentist
Enumeration Date: Apr 15, 2019
Last Updated: Apr 26, 2019

Practice Location

Address: 1825 W POINTE DR
City: Oshkosh
State: Wisconsin
ZIP Code: 54902-4174
Phone: (608) 833-2213

Authorized Official

Name: OLGA GRENOVA
Title: CONTROLLER
Phone: (608) 215-5899

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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