Organization
GREGORY A. SANTARELLI DDS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA R LEE (OFFICE MANAGER)
(262) 654-6770
Entity
Organization
Contact information
Practice address
5017 GREEN BAY RD STE 138, KENOSHA, WI 53144-1782
(262) 654-6770
(262) 654-6727
Mailing address
5017 GREEN BAY RD STE 138, KENOSHA, WI 53144-1782
(262) 654-6770
(262) 654-6727
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5188015
WI
Other
Enumeration date
01/30/2008
Last updated
10/05/2009
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