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Organization

PRAIRIE LAKES DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ADAM FORSTER (PRESIDENT OWNER DOCTOR)
(920) 623-5559
Entity
Organization

Contact information

Practice address
2804 PRAIRIE LAKES DRIVE, SUN PRAIRIE, WI 53590
(608) 825-3333
(608) 825-3444
Mailing address
2804 PRAIRIE LAKES DRIVE, SUN PRAIRIE, WI 53590
(608) 825-3333
(608) 825-3444

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
01/10/2014
Last updated
01/10/2014
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