Organization
WISCONSIN DENTAL GROUP, S.C.
Active
Parent organization
WISCONSIN DENTAL GROUP, S.C.
Other names
ForwardDental Franklin
Organization subpart
Yes
Provider details
NPI number
Legal business name
WISCONSIN DENTAL GROUP, S.C.
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
7740 S LOVERS LANE RD STE 450, FRANKLIN, WI 53132-2212
(414) 963-2301
Mailing address
7740 S LOVERS LANE RD STE 450, FRANKLIN, WI 53132-2212
(414) 963-2301
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
04/15/2022
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