| Lake Country Dentistry, L.l.c. | |
|
175 E Wisconsin Ave Oconomowoc WI 53066-3057 | |
| (262) 567-6003 | |
| (262) 567-6018 |
| Full Name | Lake Country Dentistry, L.l.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 175 E Wisconsin Ave, Oconomowoc, Wisconsin |
| Authorized Official Name and Position | James Jon Cotey (GENERAL MANAGER) |
| Authorized Official Contact | 2625676003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Country Dentistry, L.l.c. 175 E Wisconsin Ave Oconomowoc WI 53066-3057 Ph: (262) 567-6003 | Lake Country Dentistry, L.l.c. 175 E Wisconsin Ave Oconomowoc WI 53066-3057 Ph: (262) 567-6003 |
| NPI Number | 1487868493 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487868493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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