| Oak Ridge Dental Clinic,sc | |
|
101 Oakridge Court Suite C Watertown WI 53094-4100 | |
| (920) 261-5400 | |
| (920) 261-1590 |
| Full Name | Oak Ridge Dental Clinic,sc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 101 Oakridge Court, Watertown, Wisconsin |
| Authorized Official Name and Position | Michael J Wertz (OWNER) |
| Authorized Official Contact | 9202615400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Ridge Dental Clinic,sc 101 Oakridge Court Suite C Watertown WI 53094-4100 Ph: (920) 261-5400 | Oak Ridge Dental Clinic,sc 101 Oakridge Court Suite C Watertown WI 53094-4100 Ph: (920) 261-5400 |
| NPI Number | 1104950336 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104950336 | NPI | - | NPPES |
| 33741400 | Medicaid | WI | |
| 33354400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4872 (Wisconsin) | Primary |
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