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Organization

GREAT RIVER ORTHODONTIC SPECIALISTS, SC

Active
Other names
Ross Orthodontics
Organization subpart
No

Provider details

NPI number
Authorized official
LORI AMIDON (PATIENT ACCOUNTS MGR)
(715) 598-7473
Entity
Organization

Contact information

Practice address
2215 VINE ST STE B, HUDSON, WI 54016-5862
(715) 808-8379
Mailing address
3902 OAKWOOD HILLS PKWY, EAU CLAIRE, WI 54701-7780

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Enumeration date
03/07/2022
Last updated
03/07/2022
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