Organization
DENTAL CARE PROVIDERS OF AMERICA
Active
Other names
Dental Care of Kenosha
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM RYAN KISKER D.M.D. (PRESIDENT)
(224) 645-4929
Entity
Organization
Contact information
Practice address
3715 WASHINGTON RD, KENOSHA, WI 53144-1629
(262) 237-6238
Mailing address
PO BOX 788, KENOSHA, WI 53141-0788
(262) 842-2877
(877) 725-4332
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1001058-15
WI
Other
Enumeration date
06/15/2015
Last updated
06/15/2015
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