| Sparta Dental Center Sc | |
|
3000 Riley Rd Sparta WI 54656-6588 | |
| (608) 269-5282 | |
| (608) 269-6315 |
| Full Name | Sparta Dental Center Sc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3000 Riley Rd, Sparta, Wisconsin |
| Authorized Official Name and Position | Jennifer L Knoll (OWNER) |
| Authorized Official Contact | 6082695282 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sparta Dental Center Sc 3000 Riley Rd Sparta WI 54656-6588 Ph: (608) 269-5282 | Sparta Dental Center Sc 3000 Riley Rd Sparta WI 54656-6588 Ph: (608) 269-5282 |
| NPI Number | 1174701676 |
|---|---|
| Provider Enumeration Date | 02/06/2008 |
| Last Update Date | 02/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174701676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5770015 (Wisconsin) | Primary |
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