Organization
FAMILY DENTISTRY OF WEST SALEM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG JAMES FORSBERG DDS (PRESIDENT)
(608) 786-1632
Entity
Organization
Contact information
Practice address
210 N LEONARD ST, WEST SALEM, WI 54669-1623
(608) 786-1632
(608) 786-0225
Mailing address
210 N LEONARD ST, WEST SALEM, WI 54669-1623
(608) 786-1632
(608) 786-0225
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2948
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33441300
—
WI
Enumeration date
02/15/2007
Last updated
08/02/2010
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