Organization
NORTHPARK DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENIE KUBLE (CONTACT OFFICER)
(920) 450-0157
Entity
Organization
Contact information
Practice address
235 W PRAIRIE VIEW RD STE 1, CHIPPEWA FALLS, WI 54729-3639
(715) 720-9125
Mailing address
235 W PRAIRIE VIEW RD STE 1, CHIPPEWA FALLS, WI 54729-3639
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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