Organization
OWEN FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL NICHOLSON (DENTIST AND LLC OWNER)
(715) 721-5867
Entity
Organization
Contact information
Practice address
202 N CENTRAL AVE, OWEN, WI 54460-9785
(715) 229-2299
Mailing address
202 N CENTRAL AVE, OWEN, WI 54460-9785
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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