Organization
OAK RIDGE DENTAL CLINIC,SC
Active
Other names
Associated Dentists of Watertown
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J WERTZ D.D.S. (OWNER)
(920) 261-5400
Entity
Organization
Contact information
Practice address
101 OAKRIDGE COURT, SUITE C, WATERTOWN, WI 53094-4100
(920) 261-5400
(920) 261-1590
Mailing address
101 OAKRIDGE COURT, SUITE C, WATERTOWN, WI 53094-4100
(920) 261-5400
(920) 261-1590
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4872
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33354400
—
WI
05
—
33741400
—
WI
Enumeration date
03/16/2007
Last updated
08/22/2020
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