Organization
DEERWOOD ORTHODONTICS, LLC
Active
Parent organization
DEERWOOD ORTHODONTICS, LLC
Other names
Deerwood Orthodontics Racine
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEERWOOD ORTHODONTICS, LLC
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
1532 S GREEN BAY RD STE 100, MOUNT PLEASANT, WI 53406-4468
(262) 632-3300
Mailing address
1532 S GREEN BAY RD STE 100, MOUNT PLEASANT, WI 53406-4468
(262) 632-3300
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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