| De Pere Family Dentistry Llc | |
|
1001 N Broadway De Pere WI 54115-2609 | |
| (920) 336-2500 | |
| (920) 336-4684 |
| Full Name | De Pere Family Dentistry Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1001 N Broadway, De Pere, Wisconsin |
| Authorized Official Name and Position | Cyril Joseph Van Sistine (PARTNER / MANAGER) |
| Authorized Official Contact | 9203362500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| De Pere Family Dentistry Llc 1001 N Broadway De Pere WI 54115-2609 Ph: (920) 336-2500 | De Pere Family Dentistry Llc 1001 N Broadway De Pere WI 54115-2609 Ph: (920) 336-2500 |
| NPI Number | 1225307267 |
|---|---|
| Provider Enumeration Date | 12/20/2011 |
| Last Update Date | 12/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225307267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5001499 (Wisconsin) | Primary |
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