| Southwest Dental Group, S.c. | |
|
2601 Taylor Ave Racine WI 53403-2865 | |
| (262) 632-3156 | |
| (262) 632-3063 |
| Full Name | Southwest Dental Group, S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2601 Taylor Ave, Racine, Wisconsin |
| Authorized Official Name and Position | Richard L. Defurio (OWNER) |
| Authorized Official Contact | 2626323156 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Dental Group, S.c. 2601 Taylor Ave Racine WI 53403-2865 Ph: (262) 632-3156 | Southwest Dental Group, S.c. 2601 Taylor Ave Racine WI 53403-2865 Ph: (262) 632-3156 |
| NPI Number | 1003942319 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003942319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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