Organization
GURNEECTD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCH WEILAND (ASSISTANT CONTROLLER)
(608) 343-0818
Entity
Organization
Contact information
Practice address
3930 WASHINGTON ST, GURNEE, IL 60031-5702
(847) 623-4888
Mailing address
8025 EXCELSIOR DR, MADISON, WI 53717-1900
(608) 833-2212
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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