Individual
DANIEL OH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7500 GREEN BAY RD STE 200, KENOSHA, WI 53142-4045
(714) 452-7178
Mailing address
7500 GREEN BAY RD, KENOSHA, WI 53142-4059
(714) 452-7178
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6001145-15
WI
122300000X
Dentist
9094724-9921
UT
1223E0200X
Endodontics
Primary
021.003070
IL
1223G0001X
General Practice Dentistry
019.031524
IL
Other
Enumeration date
08/21/2014
Last updated
01/22/2024
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