EDP OF WISCONSIN, SC

OCONOMOWOC, WI
NPI1033671912
Entity TypeOrganization
Authorized ContactROSEANNE BRUNENKANT
Director Of Integrations
312-937-3619
Organization Subpart ?Yes
Primary Taxonomy261QD0000X Clinic/Center Dental
Enumeration Date2019-04-01
Last Update Date2019-09-16
Business Address
EDP OF WISCONSIN, SC
820 SUMMIT AVE
OCONOMOWOC, WI 53066-3973
Phone number: 312-800-1270
Mailing Address
EDP OF WISCONSIN, SC
141 W JACKSON BLVD STE 210
CHICAGO, IL 60604-3048
Phone number: 312-937-3619
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