| Beloit Dental | |
|
1454 E Huebbe Pkwy Beloit WI 53511-1714 | |
| (608) 362-0672 | |
| (608) 362-4960 |
| Full Name | Beloit Dental |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1454 E Huebbe Pkwy, Beloit, Wisconsin |
| Authorized Official Name and Position | Lawrence Groh (OWNER/PRESIDENT) |
| Authorized Official Contact | 6308335110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beloit Dental 333 W 1st St Elmhurst IL 60126-2641 Ph: (630) 833-5110 | Beloit Dental 1454 E Huebbe Pkwy Beloit WI 53511-1714 Ph: (608) 362-0672 |
| NPI Number | 1326473927 |
|---|---|
| Provider Enumeration Date | 09/13/2013 |
| Last Update Date | 09/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326473927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 019014858 (Illinois) | Primary |
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