Organization
MYOFUNCTIONAL ORTHODONTIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK KURCHAK DDS MS (OWNER)
(520) 491-0799
Entity
Organization
Contact information
Practice address
1266 W MAIN ST STE 1, SUN PRAIRIE, WI 53590-1922
(608) 471-8740
Mailing address
1266 W MAIN ST STE 1, SUN PRAIRIE, WI 53590-1922
(608) 471-8740
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
01/13/2026
Last updated
01/13/2026
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