| Mork Dental, Sc | |
|
241 N. Main St. Cochrane WI 54622 | |
| (608) 248-2442 | |
| (608) 248-3132 |
| Full Name | Mork Dental, Sc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 241 N. Main St., Cochrane, Wisconsin |
| Authorized Official Name and Position | Desiree M Mork (OWNER) |
| Authorized Official Contact | 6086873571 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mork Dental, Sc Po Box 367 Fountain City WI 54629-0367 Ph: (608) 687-3571 | Mork Dental, Sc 241 N. Main St. Cochrane WI 54622 Ph: (608) 248-2442 |
| NPI Number | 1124343025 |
|---|---|
| Provider Enumeration Date | 04/02/2010 |
| Last Update Date | 04/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124343025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5882015 (Wisconsin) | Primary |
| 1223G0001X | Dentist - General Practice | 6284015 (Wisconsin) | Secondary |
Roland W Pardun Dds Sc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 241 N Main St, Cochrane, WI 54622 Phone: 608-248-2442 Fax: 608-248-3132 |