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Organization
CHILDREN'S DENTAL CARE OF KENOSHA
Active
Organization
CHILDREN'S DENTAL CARE OF KENOSHA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS M CONNOLLY DDS MS (PRESIDENT)
(262) 658-3488
Entity
Organization
Contact information
Practice address
2901 35TH ST, KENOSHA, WI 53140-5119
(262) 658-3488
(262) 658-3433
Mailing address
2901 35TH ST, KENOSHA, WI 53140-5119
(262) 658-3488
(262) 658-3433
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
NULL
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
08/11/2006
Last updated
08/22/2020
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