Provider First Line Business Practice Location Address:
72718 MAPLE STREET
Provider Second Line Business Practice Location Address:
BAD RIVER HEALTH CLINIC DENTAL
Provider Business Practice Location Address City Name:
ODANAH
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54861
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-682-7133
Provider Business Practice Location Address Fax Number:
715-685-7848
Provider Enumeration Date:
05/03/2011