| Dentistry Of West Bend, Ltd. | |
|
1270 Chestnut St West Bend WI 53095-3130 | |
| (262) 334-0316 | |
| Not Available |
| Full Name | Dentistry Of West Bend, Ltd. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1270 Chestnut St, West Bend, Wisconsin |
| Authorized Official Name and Position | Jared John Harding (OWNER/DENTIST) |
| Authorized Official Contact | 6088860223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentistry Of West Bend, Ltd. 1270 Chestnut St West Bend WI 53095-3130 Ph: (262) 334-0316 | Dentistry Of West Bend, Ltd. 1270 Chestnut St West Bend WI 53095-3130 Ph: (262) 334-0316 |
| NPI Number | 1437552841 |
|---|---|
| Provider Enumeration Date | 09/29/2014 |
| Last Update Date | 09/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437552841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 6537-15 (Wisconsin) | Primary |
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