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Organization

FENNIMORE DENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ZHENYU LIANG D.D.S. (GENERAL DENTIST)
(608) 822-3770
Entity
Organization

Contact information

Practice address
220 LINCOLN AVENUE, FENNIMORE, WI 53809
(608) 822-3770
(608) 822-7680
Mailing address
220 LINCOLN AVENUE, FENNIMORE, WI 53809
(608) 822-3770
(608) 822-7680

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03359042
NY
Enumeration date
12/06/2018
Last updated
12/06/2018
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