Organization
ST. MARYS DEAN VENTURES INC.
Active
Parent organization
ST. MARYS DEAN VENTURES INC.
Other names
AYAZ M SAMADANI MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. MARYS DEAN VENTURES INC.
Authorized official
AMY J GRINNELL (CHIEF FINANCIAL OFFICER)
(608) 260-3586
Entity
Organization
Contact information
Practice address
148 WARREN ST, STE A, BEAVER DAM, WI 53916-3061
(920) 887-7731
(920) 887-3201
Mailing address
148 WARREN ST, STE A, BEAVER DAM, WI 53916-3061
(920) 887-7731
(920) 887-3201
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137082516
OFFICE OF WORKERS COMP
WI
05
—
32824600
—
WI
01
—
M43
DEAN HEALTH INSURANCE
WI
Enumeration date
06/19/2006
Last updated
10/29/2021
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