Organization
LOOMIS ROAD DENTAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AARON BUSHONG DDS (DENTIST/OWNER)
(715) 573-3546
Entity
Organization
Contact information
Practice address
9700 W LOOMIS RD, FRANKLIN, WI 53132-9701
(414) 529-3933
Mailing address
301 N 17TH AVE STE 200, WAUSAU, WI 54401-4225
(715) 573-3546
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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