Organization
HALLQUIST DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS HALLQUIST DDS (DENTIST)
(920) 235-6070
Entity
Organization
Contact information
Practice address
2163 W 9TH AVE, OSHKOSH, WI 54904-8043
(920) 235-6070
(920) 235-5668
Mailing address
2163 W 9TH AVE, OSHKOSH, WI 54904-8043
(920) 235-6070
(920) 235-5668
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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