Organization
NORTHWOODS DENTAL SLEEP THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARRIN J GREMBAN DDS (OWNER)
(715) 479-6100
Entity
Organization
Contact information
Practice address
865 N RAILROAD ST, EAGLE RIVER, WI 54521-8834
(715) 479-6100
Mailing address
865 N RAILROAD ST, EAGLE RIVER, WI 54521-8834
(715) 479-6100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5242-15
WI
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
02/26/2013
Last updated
10/13/2015
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