| East Troy Family Dental Center Sc | |
|
2481 Executive Dr East Troy WI 53120 | |
| (262) 642-5695 | |
| (262) 642-5395 |
| Full Name | East Troy Family Dental Center Sc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2481 Executive Dr, East Troy, Wisconsin |
| Authorized Official Name and Position | Gregory A Nyffeler (OWNER PRESIDENT) |
| Authorized Official Contact | 2626425695 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Troy Family Dental Center Sc Po Box 642 East Troy WI 53120 Ph: (262) 642-5695 | East Troy Family Dental Center Sc 2481 Executive Dr East Troy WI 53120 Ph: (262) 642-5695 |
| NPI Number | 1376607408 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376607408 | NPI | - | NPPES |
| 38368500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Behrend Family Dentistry And Associates, S.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2481 Executive Dr, East Troy, WI 53120 Phone: 262-642-5695 | |
Wanezek Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: W3278 Main Street, East Troy, WI 53120 Phone: 262-642-5881 Fax: 262-642-7252 |