| Children's Dental Clinic Of Green Bay, S.c. | |
|
534 Redbird Cir De Pere WI 54115-8785 | |
| (920) 336-4002 | |
| (920) 336-4112 |
| Full Name | Children's Dental Clinic Of Green Bay, S.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 534 Redbird Cir, De Pere, Wisconsin |
| Authorized Official Name and Position | Margaret Ann Miller (PEDIATRIC DENTIST) |
| Authorized Official Contact | 9203364002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dental Clinic Of Green Bay, S.c. 534 Redbird Cir De Pere WI 54115-8785 Ph: (920) 336-4002 | Children's Dental Clinic Of Green Bay, S.c. 534 Redbird Cir De Pere WI 54115-8785 Ph: (920) 336-4002 |
| NPI Number | 1205905619 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 01/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205905619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 4176 (Wisconsin) | Primary |
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