| Sun Prairie Family Dentistry Llc | |
|
180 Wilburn Rd Sun Prairie WI 53590-1476 | |
| (608) 833-2213 | |
| Not Available |
| Full Name | Sun Prairie Family Dentistry Llc |
|---|---|
| Speciality | Dentist |
| Location | 180 Wilburn Rd, Sun Prairie, Wisconsin |
| Authorized Official Name and Position | Olga Grenova (DIR OF ACCOUNTING) |
| Authorized Official Contact | 6088332213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sun Prairie Family Dentistry Llc 8025 Excelsior Dr Madison WI 53717-1900 Ph: (608) 833-2213 | Sun Prairie Family Dentistry Llc 180 Wilburn Rd Sun Prairie WI 53590-1476 Ph: (608) 833-2213 |
| NPI Number | 1730726555 |
|---|---|
| Provider Enumeration Date | 12/01/2019 |
| Last Update Date | 12/01/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730726555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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