Organization
DEERWOOD ORTHODONTICS, LLC
Active
Parent organization
DEERWOOD ORTHODONTICS, LLC
Other names
Deerwood Orthodontics Stone Ridge
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEERWOOD ORTHODONTICS, LLC
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
N14W23833 STONE RIDGE DR STE 100, WAUKESHA, WI 53188-1189
(262) 524-1072
(262) 524-9225
Mailing address
N14W23833 STONE RIDGE DR STE 100, WAUKESHA, WI 53188-1189
(262) 524-1072
(262) 524-9225
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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