| Otter Creek Dental, Llc | |
|
105 Kelly Way Hortonville WI 54944-8755 | |
| (920) 740-8706 | |
| Not Available |
| Full Name | Otter Creek Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 105 Kelly Way, Hortonville, Wisconsin |
| Authorized Official Name and Position | Branden Goetsch (OWNER DENTIST) |
| Authorized Official Contact | 9207408706 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Otter Creek Dental, Llc 105 Kelly Way Hortonville WI 54944-8755 Ph: () - | Otter Creek Dental, Llc 105 Kelly Way Hortonville WI 54944-8755 Ph: (920) 740-8706 |
| NPI Number | 1265096812 |
|---|---|
| Provider Enumeration Date | 04/30/2019 |
| Last Update Date | 04/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265096812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Dr. Clint Dunathan Sc Smiles By Design Sc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 Towne Drive, Hortonville, WI 54944 Phone: 920-779-4533 Fax: 920-779-4333 | |
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