De Pere Smiles S.c. | |
277 N 9th St De Pere WI 54115-1548 | |
(920) 336-6594 | |
(920) 336-7132 |
Full Name | De Pere Smiles S.c. |
---|---|
Speciality | Dentist - General Practice |
Location | 277 N 9th St, De Pere, Wisconsin |
Authorized Official Name and Position | Christopher James Peterson (PRESIDENT/OWNER/DENTIST) |
Authorized Official Contact | 9203366594 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
De Pere Smiles S.c. 277 N 9th St De Pere WI 54115-1548 Ph: (920) 336-6594 | De Pere Smiles S.c. 277 N 9th St De Pere WI 54115-1548 Ph: (920) 336-6594 |
NPI Number | 1225568983 |
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Provider Enumeration Date | 06/15/2017 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225568983 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 1001273-15 (Wisconsin) | Primary |
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