Organization
DEER CREEK DENTAL CLINIC, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHERINE E KONZE PHR (OFFICE ADMINISTRATOR)
(608) 372-5000
Entity
Organization
Contact information
Practice address
820 N SUPERIOR AVE, TOMAH, WI 54660-1120
(608) 372-5000
Mailing address
820 N SUPERIOR AVE, TOMAH, WI 54660-1120
(608) 372-5000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3857
WI
Other
Enumeration date
09/28/2009
Last updated
03/13/2014
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