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1003942319
SOUTHWEST DENTAL GROUP, S.C.
RACINE, WI
NPI
1003942319
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Entity Type
Organization
Authorized Contact
RICHARD L. DEFURIO
Owner
262-632-3156
Organization Subpart ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
Enumeration Date
2007-02-23
Last Update Date
2020-08-22
Business Address
SOUTHWEST DENTAL GROUP, S.C.
2601 TAYLOR AVE
RACINE, WI 53403-2865
Phone number: 262-632-3156
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Mailing Address
SOUTHWEST DENTAL GROUP, S.C.
2601 TAYLOR AVE
RACINE, WI 53403-2865
Phone number: 262-632-3156
Copy
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