Organization
BEAVER DAM ENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
K SCOTT ABRAMS CPA (CFO)
(920) 887-4041
Entity
Organization
Contact information
Practice address
707 S UNIVERSITY AVE, BEAVER DAM, WI 53916-3027
(920) 887-6383
Mailing address
707 S UNIVERSITY AVE, BEAVER DAM, WI 53916-3027
(920) 887-6383
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
09/16/2008
Last updated
01/23/2009
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