Organization
ADVANCED ORTHODONTICS OF WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN D GOCHNOUR DDS, MS (DR./OWNER)
(608) 271-9293
Entity
Organization
Contact information
Practice address
5605 ODANA RD, MADISON, WI 53719-1207
(608) 271-9293
(608) 204-9216
Mailing address
5605 ODANA RD, MADISON, WI 53719-1207
(608) 271-9293
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5066
TX
Other
Enumeration date
06/27/2016
Last updated
06/27/2016
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