Organization
DOWNTOWN DENTAL, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD LESLIE HAFDAHL D.D.S. (PRESIDENT)
(715) 294-2334
Entity
Organization
Contact information
Practice address
114 CASCADE ST., OSCEOLA, WI 54020-0387
(715) 294-2334
(715) 294-2220
Mailing address
114 CASCADE ST., OSCEOLA, WI 54020-0387
(715) 294-2334
(715) 294-2220
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5001118
WI
Other
Enumeration date
09/22/2006
Last updated
08/22/2020
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