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Organization

OSHKOSH FAMILY DENTAL 2, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OLGA GRENOVA (CONTROLLER)
(608) 215-5899
Entity
Organization

Contact information

Practice address
1825 W POINTE DR, OSHKOSH, WI 54902-4174
(608) 833-2213
Mailing address
8025 EXCELSIOR DR, MADISON, WI 53717-1900
(608) 215-5899

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
04/15/2019
Last updated
04/26/2019
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