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Organization
PLATTEVILLE DENTAL LLC
Active
Organization
PLATTEVILLE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA JACQUINOT (BUSINESS MANAGER)
(608) 852-7298
Entity
Organization
Contact information
Practice address
1270 N WATER ST, PLATTEVILLE, WI 53818-1450
(608) 348-2393
(608) 348-4430
Mailing address
1270 N WATER ST, PLATTEVILLE, WI 53818-1450
(608) 348-2393
(608) 348-4430
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6103
WI
Other
Enumeration date
03/24/2009
Last updated
03/24/2009
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