Organization
TERRY L. KIPPA DDS SC
Active
Other names
Terry L. Kippa, DDS and Gordon D. Korthals, DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON DEAN KORTHALS DDS (CORPORATE PRESIDENT)
(920) 233-8882
Entity
Organization
Contact information
Practice address
600 S MAIN ST, OSHKOSH, WI 54902-6074
(920) 233-8882
(920) 303-2736
Mailing address
600 S MAIN ST, OSHKOSH, WI 54902-6074
(920) 233-8882
(920) 303-2736
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
4375-015
WI
Other
Enumeration date
06/01/2008
Last updated
06/01/2008
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