Menomonie Dental, LLC
Dentist in Menomonie, WI. Organization (NPI-2).
NPI number1972016830
StatusActive
Last updated in NPPESNov 14, 2017
Details
- NPI
- 1972016830
- Entity type
- Organization (NPI-2)
- Legal business name
- Menomonie Dental, LLC
- Organization subpart
- No
- Enumeration date
- Nov 14, 2017
- Last updated
- Nov 14, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Practice location
1603 Stout RdMenomonie, WI 54751-2989
Phone 715-235-6858
Mailing address
1603 Stout RdMenomonie, WI 54751-2989
Phone 715-235-6858
Authorized official
Olga Grenova
Director Of Accounting
6088332213
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- Katherine Josephine TrimbleNPI 1114716420
- Danny Roger Wood, DDSNPI 1295956282
All 8 Dentist providers in Menomonie · All 575 providers in Menomonie
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