Organization
RICHLAND FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRENCE MOEN (OWNER)
(608) 647-3222
Entity
Organization
Contact information
Practice address
1313 W SEMINARY ST STE 200, RICHLAND CENTER, WI 53581-2067
(608) 649-3222
Mailing address
1313 W SEMINARY ST STE 200, RICHLAND CENTER, WI 53581-2067
(608) 649-3222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6287-15
WI
Other
Enumeration date
07/03/2008
Last updated
07/03/2008
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