| Dental Care Of Kenosha | |
|
3715 Washington Rd Kenosha WI 53144-1629 | |
| (262) 237-6238 | |
| Not Available |
| Full Name | Dental Care Of Kenosha |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3715 Washington Rd, Kenosha, Wisconsin |
| Authorized Official Name and Position | William Ryan Kisker (PRESIDENT) |
| Authorized Official Contact | 2246454929 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Care Of Kenosha Po Box 788 Kenosha WI 53141-0788 Ph: (262) 842-2877 | Dental Care Of Kenosha 3715 Washington Rd Kenosha WI 53144-1629 Ph: (262) 237-6238 |
| NPI Number | 1104207232 |
|---|---|
| Provider Enumeration Date | 06/15/2015 |
| Last Update Date | 06/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104207232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 1001058-15 (Wisconsin) | Primary |
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