| Children's Dental Center S.c. | |
|
230 N Sawyer St Oshkosh WI 54902-4280 | |
| (920) 233-1030 | |
| (920) 233-7398 |
| Full Name | Children's Dental Center S.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 230 N Sawyer St, Oshkosh, Wisconsin |
| Authorized Official Name and Position | Phillip Andrew Baker (PRESIDENT) |
| Authorized Official Contact | 9202331030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dental Center S.c. 230 N Sawyer St Oshkosh WI 54902-4280 Ph: (920) 233-1030 | Children's Dental Center S.c. 230 N Sawyer St Oshkosh WI 54902-4280 Ph: (920) 233-1030 |
| NPI Number | 1730339367 |
|---|---|
| Provider Enumeration Date | 09/18/2008 |
| Last Update Date | 09/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730339367 | NPI | - | NPPES |
| 33720600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4436-015 (Wisconsin) | Primary |
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