Organization
MORK DENTAL, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DESIREE M MORK D.D.S. (OWNER)
(608) 687-3571
Entity
Organization
Contact information
Practice address
241 N. MAIN ST., COCHRANE, WI 54622
(608) 248-2442
(608) 248-3132
Mailing address
PO BOX 367, FOUNTAIN CITY, WI 54629-0367
(608) 687-3571
(608) 687-6007
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5882015
WI
1223G0001X
General Practice Dentistry
6284015
WI
Other
Enumeration date
04/02/2010
Last updated
04/02/2010
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