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Organization
ORCHARD DENTAL SC
Active
Organization
ORCHARD DENTAL SC
Active
Other names
WISCONSIN SMILES
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERTO EDGARDO MONTEAGUDO DDS (OWNER)
(414) 383-5833
Entity
Organization
Contact information
Practice address
1469 S 70TH ST, WEST ALLIS, WI 53214-4814
(414) 383-5833
(414) 383-0233
Mailing address
1469 S 70TH ST, WEST ALLIS, WI 53214-4814
(414) 383-5833
(414) 383-0233
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4186
WI
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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