| Advanced Dental Specialists, Llc | |
|
3030 N Ballard Rd Appleton WI 54911-8707 | |
| (414) 543-3301 | |
| (414) 543-1532 |
| Full Name | Advanced Dental Specialists, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3030 N Ballard Rd, Appleton, Wisconsin |
| Authorized Official Name and Position | Celia Hayes (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175402100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dental Specialists, Llc 3030 N Ballard Rd Appleton WI 54911-8707 Ph: (414) 543-3301 | Advanced Dental Specialists, Llc 3030 N Ballard Rd Appleton WI 54911-8707 Ph: (414) 543-3301 |
| NPI Number | 1215685110 |
|---|---|
| Provider Enumeration Date | 03/10/2022 |
| Last Update Date | 03/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215685110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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