Organization
OMALLEY DENTISTRY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLEN MARTIN OMALLEY DDS (DENTIST OWNER)
(414) 425-4005
Entity
Organization
Contact information
Practice address
8555 W FOREST HM AVE, SUITE 101, GREENFIELD, WI 53228
(414) 425-4005
(414) 529-9777
Mailing address
8555 W FOREST HM AVE, SUITE 101, GREENFIELD, WI 53228
(414) 425-4005
(414) 529-9777
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3802
WI
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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