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1205364197
KENOSHA DENTIST LLC
KENOSHA, WI
NPI
1205364197
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Entity Type
Organization
Authorized Contact
DOMINIC KACZYNSKI
Business Manager
262-244-0700
Organization Subpart ?
No
Primary Taxonomy
1223G0001X Dentist General Practice
Enumeration Date
2017-05-23
Last Update Date
2017-05-23
Business Address
KENOSHA DENTIST LLC
5455 SHERIDAN RD STE 201
KENOSHA, WI 53140-3752
Phone number: 262-244-0700
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Mailing Address
KENOSHA DENTIST LLC
5455 SHERIDAN RD STE 201
KENOSHA, WI 53140-3752
Phone number:
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