| Menomonie Dental, Llc | |
|
1603 Stout Rd Menomonie WI 54751-2989 | |
| (715) 235-6858 | |
| Not Available |
| Full Name | Menomonie Dental, Llc |
|---|---|
| Speciality | Dentist |
| Location | 1603 Stout Rd, Menomonie, Wisconsin |
| Authorized Official Name and Position | Olga Grenova (DIRECTOR OF ACCOUNTING) |
| Authorized Official Contact | 6088332213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Menomonie Dental, Llc 1603 Stout Rd Menomonie WI 54751-2989 Ph: (715) 235-6858 | Menomonie Dental, Llc 1603 Stout Rd Menomonie WI 54751-2989 Ph: (715) 235-6858 |
| NPI Number | 1972016830 |
|---|---|
| Provider Enumeration Date | 11/14/2017 |
| Last Update Date | 11/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972016830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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