Organization
SPARTA DENTAL CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L KNOLL DDS (OWNER)
(608) 269-5282
Entity
Organization
Contact information
Practice address
3000 RILEY RD, SPARTA, WI 54656-6588
(608) 269-5282
(608) 269-6315
Mailing address
3000 RILEY RD, SPARTA, WI 54656-6588
(608) 269-5282
(608) 269-6315
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5770015
WI
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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