Organization
HALLQUIST FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLGA GRENOVA (DIR OF ACCOUNTING)
(608) 833-2213
Entity
Organization
Contact information
Practice address
2163 W 9TH AVE, OSHKOSH, WI 54904-8043
(608) 833-2213
Mailing address
8025 EXCELSIOR DR, MADISON, WI 53717-1900
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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