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Organization
TANNLEGER AS ORAL AND MAXILLOFACIAL SURGERY SC
Active
Organization
TANNLEGER AS ORAL AND MAXILLOFACIAL SURGERY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD L GUTTU DDS (OWNER)
(608) 362-9391
Entity
Organization
Contact information
Practice address
2359 MURPHY WOODS RD, BELOIT, WI 53511-2343
(608) 362-9391
(608) 362-8020
Mailing address
2359 MURPHY WOODS RD, BELOIT, WI 53511-2343
(608) 362-9391
(608) 362-8020
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
—
—
Other
Enumeration date
03/11/2010
Last updated
03/11/2010
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