| Lake Geneva Dental Care Llc | |
|
580 Broad St Lake Geneva WI 53147-1420 | |
| (262) 248-2773 | |
| (262) 248-3895 |
| Full Name | Lake Geneva Dental Care Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 580 Broad St, Lake Geneva, Wisconsin |
| Authorized Official Name and Position | Lawrence Groh (OWNER) |
| Authorized Official Contact | 6308335110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Geneva Dental Care Llc 580 Broad St Lake Geneva WI 53147-1420 Ph: (262) 248-2773 | Lake Geneva Dental Care Llc 580 Broad St Lake Geneva WI 53147-1420 Ph: (262) 248-2773 |
| NPI Number | 1083732101 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083732101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5788 (Wisconsin) | Primary |
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