| Oak Creek Dental Care Llc | |
|
132 E Drexel Ave Oak Creek WI 53154-2123 | |
| (414) 762-9010 | |
| (414) 570-5492 |
| Full Name | Oak Creek Dental Care Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 132 E Drexel Ave, Oak Creek, Wisconsin |
| Authorized Official Name and Position | Daniel Richard Koester (OWNER/MANAGER) |
| Authorized Official Contact | 4147629010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Creek Dental Care Llc 132 E Drexel Ave Oak Creek WI 53154-2123 Ph: (414) 762-9010 | Oak Creek Dental Care Llc 132 E Drexel Ave Oak Creek WI 53154-2123 Ph: (414) 762-9010 |
| NPI Number | 1851784599 |
|---|---|
| Provider Enumeration Date | 03/05/2015 |
| Last Update Date | 03/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851784599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2481-15 (Wisconsin) | Primary |
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