Organization
DRIFTLESS DENTAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLGA GRENOVA (DIRECTOR OF ACCOUNTING)
(608) 833-2213
Entity
Organization
Contact information
Practice address
3143 STATE RD STE 200, LA CROSSE, WI 54601-6964
(608) 787-1700
Mailing address
3143 STATE RD STE 200, LA CROSSE, WI 54601-6964
(608) 787-1700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/14/2017
Last updated
11/14/2017
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