Organization
DENTAL 360 OAK CREEK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. IVANA BUENO (DIRECTOR)
(773) 798-9382
Entity
Organization
Contact information
Practice address
124 E DREXEL AVE, OAK CREEK, WI 53154-2123
(262) 533-8387
(262) 533-8402
Mailing address
124 E DREXEL AVE, OAK CREEK, WI 53154-2123
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/15/2022
Last updated
03/14/2024
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