BEAVER DAM DENTAL LLC

BEAVER DAM, WI
NPI1699985051
Entity TypeOrganization
Authorized ContactGENEVIEVE E POPPE
Partner
608-358-3370
Organization Subpart ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: WI  3480)
Additional Taxonomies1223G0001X Dentist, General Practice
(Licence: WI  1384G)
1223G0001X Dentist, General Practice
(Licence: WI  6749-015)
Enumeration Date2007-05-23
Last Update Date2013-01-31
Business Address
BEAVER DAM DENTAL LLC
302 N SPRING ST
BEAVER DAM, WI 53916-2044
Phone number: 920-887-8421
Mailing Address
BEAVER DAM DENTAL LLC
PO BOX 436
BEAVER DAM, WI 53916-0436
Phone number: 920-887-8421