Organization
GRANDVIEW DENTAL S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK LEE WOLFE D.D.S. (PRESIDENT AND DENTIST)
(715) 381-5556
Entity
Organization
Contact information
Practice address
900 CRESTVIEW DR, SUITE 240, HUDSON, WI 54016-9517
(715) 381-5556
(715) 381-5355
Mailing address
900 CRESTVIEW DRIVE, SUITE 240, HUDSON, WI 54016-9517
(715) 381-5556
(715) 381-5355
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4584
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33723000
—
WI
Enumeration date
03/14/2007
Last updated
08/22/2020
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