Organization
CEDAR CREEK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENIE KUBLE (CONTACT OFFICER)
(920) 450-0157
Entity
Organization
Contact information
Practice address
3101 SCHNEIDER AVE SE, SUITE 1, MENOMONIE, WI 54751-2820
(715) 233-1400
Mailing address
3101 SCHNEIDER AVE SE, SUITE 1, MENOMONIE, WI 54751-2820
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/13/2007
Last updated
08/22/2020
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