Organization
MERCY DENTAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARREN THOMAS MARABELLI (CHIEF OPERATING OFFICER)
(608) 609-4023
Entity
Organization
Contact information
Practice address
6660 UNIVERSITY AVE., MIDDLETON, WI 53562
(608) 836-1446
Mailing address
6660 UNIVERSITY AVE., MIDDLETON, WI 53562
(608) 836-1446
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
12/07/2020
Last updated
12/07/2020
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