Organization
DELEVAN FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENIE KUBLE (CONTACT OFFICER)
(920) 450-0157
Entity
Organization
Contact information
Practice address
1624 HOBBS DR, SUITE 2, DELAVAN, WI 53115-2000
(262) 740-1010
Mailing address
1624 HOBBS DR, SUITE 2, DELAVAN, WI 53115-2000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/26/2009
Last updated
03/26/2009
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