| Janesvillectd Llc | |
|
1111 Suffolk Dr Janesville WI 53546-1608 | |
| (608) 752-6848 | |
| Not Available |
| Full Name | Janesvillectd Llc |
|---|---|
| Speciality | Dentist |
| Location | 1111 Suffolk Dr, Janesville, Wisconsin |
| Authorized Official Name and Position | Mitch Weiland (ASSISTANT CONTROLLER) |
| Authorized Official Contact | 6083430818 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Janesvillectd Llc 8025 Excelsior Dr Madison WI 53717-1900 Ph: (608) 343-0818 | Janesvillectd Llc 1111 Suffolk Dr Janesville WI 53546-1608 Ph: (608) 752-6848 |
| NPI Number | 1508533621 |
|---|---|
| Provider Enumeration Date | 08/26/2021 |
| Last Update Date | 08/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508533621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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