Organization
ELKHORN FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENIE B KUBLE (ACCESS MANAGER)
(920) 450-0157
Entity
Organization
Contact information
Practice address
1525 FAIRWAY LN, ELKHORN, WI 53121-5000
(262) 723-3296
(262) 723-2556
Mailing address
1525 FAIRWAY LN, ELKHORN, WI 53121-5000
(262) 723-3296
(262) 723-2556
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/08/2021
Last updated
06/08/2021
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