Organization
DEERWOOD ORTHODONTICS, LLC
Active
Parent organization
DEERWOOD ORTHODONTICS, LLC
Other names
Deerwood Orthodontics Cudahy
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEERWOOD ORTHODONTICS, LLC
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
3527 E SQUIRE AVE, CUDAHY, WI 53110-1426
(414) 744-3500
Mailing address
3527 E SQUIRE AVE, CUDAHY, WI 53110-1426
(414) 744-3500
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3157
WI
Other
Enumeration date
06/19/2015
Last updated
03/14/2022
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