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Organization
911 DENTAL GROUP
Active
Organization
911 DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANA YAW OWUSU DMD (CEO)
(262) 900-2191
Entity
Organization
Contact information
Practice address
400 LAKE AVE, RACINE, WI 53403-1020
(262) 900-2191
Mailing address
810 THORNTON ST SE APT 1104, MINNEAPOLIS, MN 55414-3657
(773) 640-1715
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/10/2025
Last updated
02/10/2025
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