Organization
KENOSHA FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TEJPAL SINGH ATHWAL DDS (OWNER/EMPLOYEE)
(262) 697-0321
Entity
Organization
Contact information
Practice address
5707 75TH ST, KENOSHA, WI 53142-3603
(262) 697-0321
Mailing address
5707 75TH ST, KENOSHA, WI 53142-3603
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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