Organization
ORCHARD DENTAL SC
Active
Other names
WISCONSIN SMILES
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERTO EDGARDO MONTEAGUDO DDS (OWNER)
(414) 383-5833
Entity
Organization
Contact information
Practice address
1469 S 70TH ST, WEST ALLIS, WI 53214-4814
(414) 383-5833
(414) 383-0233
Mailing address
1469 S 70TH ST, WEST ALLIS, WI 53214-4814
(414) 383-5833
(414) 383-0233
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4186
WI
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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