| Advanced Dental Professionals, Llc | |
|
617 Jackson St Wausau WI 54403-5550 | |
| (715) 842-0765 | |
| Not Available |
| Full Name | Advanced Dental Professionals, Llc |
|---|---|
| Speciality | Dentist |
| Location | 617 Jackson St, Wausau, 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 |
|---|---|
| Advanced Dental Professionals, Llc 617 Jackson St Wausau WI 54403-5550 Ph: (715) 842-0765 | Advanced Dental Professionals, Llc 617 Jackson St Wausau WI 54403-5550 Ph: (715) 842-0765 |
| NPI Number | 1306359450 |
|---|---|
| Provider Enumeration Date | 11/13/2017 |
| Last Update Date | 11/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306359450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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