| Rosholt Area Dental Clinic, Llc | |
|
247 Depot St Rosholt WI 54473-9710 | |
| (715) 677-3202 | |
| Not Available |
| Full Name | Rosholt Area Dental Clinic, Llc |
|---|---|
| Speciality | Dentist |
| Location | 247 Depot St, Rosholt, Wisconsin |
| Authorized Official Name and Position | Olga Grenova (DIRECTOR OF ACCOUNTING) |
| Authorized Official Contact | 6088332213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosholt Area Dental Clinic, Llc 247 Depot St Rosholt WI 54473-9710 Ph: (715) 677-3202 | Rosholt Area Dental Clinic, Llc 247 Depot St Rosholt WI 54473-9710 Ph: (715) 677-3202 |
| NPI Number | 1518470475 |
|---|---|
| Provider Enumeration Date | 11/14/2017 |
| Last Update Date | 11/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518470475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |