Organization
MT HOREB DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENIE KUBLE (CONTACT OFFICER)
(920) 450-0157
Entity
Organization
Contact information
Practice address
303 E MAIN ST, MOUNT HOREB, WI 53572-2032
(608) 437-5519
Mailing address
303 E MAIN ST, P.O. BOX 285, MOUNT HOREB, WI 53572-2032
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/20/2012
Last updated
12/20/2012
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