| Baycare Clinic Llp | |
|
930 Maritime Dr Manitowoc WI 54220-2961 | |
| (920) 682-9121 | |
| (920) 682-7188 |
| Full Name | Baycare Clinic Llp |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 930 Maritime Dr, Manitowoc, Wisconsin |
| Authorized Official Name and Position | Chris Jay Augustian (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9204055382 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Baycare Clinic Llp Po Box 28900 Green Bay WI 54324-0900 Ph: (920) 490-9046 | Baycare Clinic Llp 930 Maritime Dr Manitowoc WI 54220-2961 Ph: (920) 682-9121 |
| NPI Number | 1134490758 |
|---|---|
| Provider Enumeration Date | 01/13/2012 |
| Last Update Date | 04/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134490758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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