Organization
KOHL DENTAL LLC
Active
Other names
Gary J Kohl DDS
Organization subpart
No
Provider details
NPI number
Authorized official
OLGA GRENOVA (DIR OF ACCOUNTING)
(608) 833-2213
Entity
Organization
Contact information
Practice address
1 CORPORATE DR STE 104, WAUSAU, WI 54401-1725
(715) 845-9297
Mailing address
1 CORPORATE DR STE 104, WAUSAU, WI 54401-1725
(715) 845-9297
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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