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Organization
CHILDREN'S DENTISTRY OF KENOSHA LLC
Active
Organization
CHILDREN'S DENTISTRY OF KENOSHA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS VALERI (PRESIDENT)
(262) 496-6196
Entity
Organization
Contact information
Practice address
9020 76TH ST STE A, PLEASANT PRAIRIE, WI 53158-1976
(262) 577-5237
Mailing address
9020 76TH ST STE A, PLEASANT PRAIRIE, WI 53158-1976
(262) 577-5237
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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