Organization
BLACK RIVER FALLS DENTAL LLC
Active
Other names
Black River Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MITCH WEILAND (SENIOR ACCOUNTANT)
(608) 343-0818
Entity
Organization
Contact information
Practice address
N6625 COUNTY ROAD A, BLACK RIVER FALLS, WI 54615-5852
(715) 284-3100
Mailing address
N6625 COUNTY ROAD A, BLACK RIVER FALLS, WI 54615-5852
(715) 284-3100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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