OrganizationActive
Advanced Dental Professionals, LLC
NPI 1306359450 · Dentist · Wausau, WI
Provider details
- NPI number
- 1306359450
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Olga Grenova, Director of Accounting(608) 833-2213
Specialties & taxonomies
Dental Providers
Practice location
617 Jackson St
Wausau, WI 54403-5550
Phone: (715) 842-0765
Approximate (ZIP-level) locationGet directions
Mailing address
617 Jackson St
Wausau, WI 54403-5550
Registry dates
- Enumerated
- 2017-11-13
- Last updated
- 2017-11-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.