Organization
JACKSON TOWN & COUNTRY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCH WEILAND (SENIOR ACCOUNTANT)
(608) 343-0818
Entity
Organization
Contact information
Practice address
N168 W20566 MAIN ST, JACKSON, WI 53037
(262) 444-0600
Mailing address
N168 W20566 MAIN ST, JACKSON, WI 53037
(262) 444-0600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/07/2020
Last updated
09/07/2020
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