Organization
OCONTO FALLS DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA VANDERLEEST (OFFICE MANAGER)
(920) 434-3950
Entity
Organization
Contact information
Practice address
248 N MAIN ST, OCONTO FALLS, WI 54154-1047
(920) 846-2171
(920) 848-2000
Mailing address
248 N MAIN ST, OCONTO FALLS, WI 54154-1047
(920) 846-2171
(920) 848-2000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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