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1497294722
MDC WEST BEND, LLC
WEST BEND, WI
NPI
1497294722
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Entity Type
Organization
Authorized Contact
BERNARD BOLKA
Member
920-579-3188
Organization Subpart ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: WI 5479015)
Enumeration Date
2017-02-20
Last Update Date
2017-02-20
Business Address
MDC WEST BEND, LLC
1625 W PARADISE DR
WEST BEND, WI 53095-7846
Phone number: 262-338-2992
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Mailing Address
MDC WEST BEND, LLC
7 SHEBOYGAN ST
FOND DU LAC, WI 54935-4281
Phone number: 920-579-3188
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