Idental LLC
NPI #1861867947 in Mt Pleasant, Wisconsin
Provider Information
- NPI Number
- 1861867947
- Entity Type
- Organization
- Organization Name
- Idental LLC
- Primary Specialty
- Dentist
- Enumeration Date
- Dec 1, 2015
- Last Updated
- Dec 1, 2015
Practice Location
- Address
- 1320 S GREEN BAY RD
- City
- Mt Pleasant
- State
- Wisconsin
- ZIP Code
- 53406-4406
- Phone
- (847) 561-1424
Authorized Official
- Name
- VIVEK VASUDEVA
- Title
- CO-CEO
- Phone
- (847) 561-1424
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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