| NPI | 1104207232 |
|---|---|
| Doing Business As | DENTAL CARE OF KENOSHA |
| Entity Type | Organization |
| Authorized Contact | WILLIAM RYAN KISKER President 224-645-4929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: WI 1001058-15) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |