Organization
HUDSON DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM OLAF KLOSTER D.D.S. (PRES.)
(715) 386-9119
Entity
Organization
Contact information
Practice address
2215 VINE ST, SUITE D, HUDSON, WI 54016-5802
(715) 386-9119
(715) 386-0303
Mailing address
2215 VINE ST, SUITE D, HUDSON, WI 54016-5802
(715) 386-9119
(715) 386-0303
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4004
WI
Other
Enumeration date
01/31/2007
Last updated
08/22/2020
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