| Baycare Clinic Llp | |
|
920 E 5th St Shawano WI 54166-2212 | |
| (715) 524-2001 | |
| (715) 524-6267 |
| Full Name | Baycare Clinic Llp |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 920 E 5th St, Shawano, Wisconsin |
| Authorized Official Name and Position | Nicole Hettmann (SENIOR PROVIDER CREDENTIALING COORD) |
| Authorized Official Contact | 9204909046 |
| 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 920 E 5th St Shawano WI 54166-2212 Ph: (715) 524-2001 |
| NPI Number | 1306117031 |
|---|---|
| Provider Enumeration Date | 01/26/2012 |
| Last Update Date | 04/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306117031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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