Wisconsin Dental Group, S.c.

NPI #1881342343 in West Bend, Wisconsin

Provider Information

NPI Number
1881342343
Entity Type
Organization
Organization Name
Wisconsin Dental Group, S.c.
Subpart
Yes (part of a larger organization)
Parent Organization
WISCONSIN DENTAL GROUP, S.C.
Primary Specialty
Dentist - General Practice
Enumeration Date
Mar 14, 2022
Last Updated
Mar 14, 2022

Practice Location

Address
1006 S MAIN ST
ZIP Code
53095-4604
Phone
(262) 346-2170

Authorized Official

Name
CELIA HAYES
Title
CREDENTIALING COORDINATOR
Phone
(217) 540-2100

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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