Juntunen Dental LLC
Dentist, General Practice in Depere, WI. Organization (NPI-2).
NPI number1821173006
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1821173006
- Entity type
- Organization (NPI-2)
- Legal business name
- Juntunen Dental LLC
- Organization subpart
- No
- Enumeration date
- Oct 26, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
115 S 8th StDepere, WI 54115-1399
Phone 920-336-9002 · Fax 920-336-8304
Mailing address
115 S 8th StDepere, WI 54115-1399
Phone 920-336-9002 · Fax 920-336-8304
Authorized official
Peter Jason Juntunen
Doctor Dentist
9203369002
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