| Antisdel Dental Clinic, S.c. | |
|
661 E Green Bay Ave Saukville WI 53080-2013 | |
| (262) 284-7111 | |
| (262) 284-1172 |
| Full Name | Antisdel Dental Clinic, S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 661 E Green Bay Ave, Saukville, Wisconsin |
| Authorized Official Name and Position | Robert James Antisdel (PRESIDENT / DENTIST) |
| Authorized Official Contact | 12622847111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Antisdel Dental Clinic, S.c. 661 E Green Bay Ave Saukville WI 53080-2013 Ph: (262) 284-7111 | Antisdel Dental Clinic, S.c. 661 E Green Bay Ave Saukville WI 53080-2013 Ph: (262) 284-7111 |
| NPI Number | 1649294257 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649294257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2485-015 / 2486-015 (Wisconsin) | Primary |
Sauk Trail Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 661 E Green Bay Ave, Saukville, WI 53080 Phone: 262-284-7111 |