Lake Geneva Dental Care Llc

NPI 1083732101 - Dentist - 1223G0001X

NPI Details
NPI 1083732101
Enumeration Date 03/27/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name LAWRENCE LAWRENCE
Position OWNER
Phone (262) 248-2773
Fax (262) 248-3895
Practice Location
580 BROAD ST
LAKE GENEVA WI, 53147-1420, US
Phone (262) 248-2773
Fax (262) 248-3895
Business Location
580 BROAD ST
LAKE GENEVA WI, 53147-1420, US
Phone (262) 248-2773
Fax (262) 248-3895
Toxanomy
Taxonomy Code 1223G0001X
License State Wisconsin
License Number 5788
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According to our database, Lake Geneva Dental Care Llc NPI is 1083732101, taxonomy code is 1223G0001X and license number is 5788, license state is located at Wisconsin. Lake Geneva Dental Care Llc physically located at 580 Broad St, Lake Geneva WI, 53147-1420. NPI Number 1033115704 has the healthcare provider type.

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1083732101 NPI number is provided on an as is basis without warranty of any kind. 1083732101 is maintained by the National Plan & Provider Enumeration System. The contents of Lake Geneva Dental Care Llc are for informational purposes only.