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Organization
OTTER CREEK DENTAL, LLC
Active
Organization
OTTER CREEK DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDEN GOETSCH DMD (OWNER DENTIST)
(920) 740-8706
Entity
Organization
Contact information
Practice address
105 KELLY WAY, HORTONVILLE, WI 54944-8755
(920) 740-8706
Mailing address
105 KELLY WAY, HORTONVILLE, WI 54944-8755
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/30/2019
Last updated
04/30/2019
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