| Oak Grove Dental Associates, Llc | |
|
1640 Main St Green Bay WI 54302-2639 | |
| (920) 468-6371 | |
| Not Available |
| Full Name | Oak Grove Dental Associates, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1640 Main St, Green Bay, Wisconsin |
| Authorized Official Name and Position | Sara Heinemeyer (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 9207334787 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Grove Dental Associates, Llc 1640 Main St Green Bay WI 54302-2639 Ph: (920) 468-6371 | Oak Grove Dental Associates, Llc 1640 Main St Green Bay WI 54302-2639 Ph: (920) 468-6371 |
| NPI Number | 1235665464 |
|---|---|
| Provider Enumeration Date | 05/09/2017 |
| Last Update Date | 05/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235665464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5001068G (Wisconsin) | Primary |
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