| Old Oaks Dental Llc | |
|
9809 39th Ave Ste 1 Pleasant Prairie WI 53158-3733 | |
| (715) 573-3868 | |
| Not Available |
| Full Name | Old Oaks Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9809 39th Ave Ste 1, Pleasant Prairie, Wisconsin |
| Authorized Official Name and Position | Aaron Bushong (OWNER) |
| Authorized Official Contact | 7155733868 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Old Oaks Dental Llc 9809 39th Ave Ste 1 Pleasant Prairie WI 53158-3733 Ph: (715) 573-3868 | Old Oaks Dental Llc 9809 39th Ave Ste 1 Pleasant Prairie WI 53158-3733 Ph: (715) 573-3868 |
| NPI Number | 1093446163 |
|---|---|
| Provider Enumeration Date | 06/20/2022 |
| Last Update Date | 06/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093446163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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