Provider Demographics
NPI:1851401863
Name:OAK FOREST DENTAL INC
Entity Type:Organization
Organization Name:OAK FOREST DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HUGGETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:608-781-4992
Mailing Address - Street 1:1062 OAK FOREST DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650
Mailing Address - Country:US
Mailing Address - Phone:608-781-4992
Mailing Address - Fax:608-781-4976
Practice Address - Street 1:1062 OAK FOREST DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650
Practice Address - Country:US
Practice Address - Phone:608-781-4992
Practice Address - Fax:608-781-4976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38392600Medicare ID - Type Unspecified