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1710478557
GLENDALE DENTAL LLC
GLENDALE, WI
NPI
1710478557
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Entity Type
Organization
Authorized Contact
CHRISTOPHER POTRYKUS
Owner
262-646-2771
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
(Licence: WI 6886)
Enumeration Date
2018-05-29
Last Update Date
2018-05-29
Business Address
GLENDALE DENTAL LLC
5150 N PORT WASHINGTON RD STE 201
GLENDALE, WI 53217-5400
Phone number: 414-964-8850
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Mailing Address
GLENDALE DENTAL LLC
920 INDIAN SPRING DR
DELAFIELD, WI 53018-2242
Phone number: 262-873-0510
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