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Organization

ACACIA LANE DENTAL, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GREGORY DANA EDWARDS D.D.S. (PRESIDENT)
(715) 365-8664
Entity
Organization

Contact information

Practice address
664 ACACIA LN, RHINELANDER, WI 54501-2873
(715) 365-8664
(715) 365-8668
Mailing address
PO BOX 1165, 664 ACACIA LANE, RHINELANDER, WI 54501-1165
(715) 365-8664
(715) 365-8668

Taxonomy

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

Other

Enumeration date
08/31/2006
Last updated
08/22/2020
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