| Kaukauna Family Dentistry, S.c. | |
|
233 Dodge St Kaukauna WI 54130-2500 | |
| (920) 766-9542 | |
| (920) 759-4439 |
| Full Name | Kaukauna Family Dentistry, S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 233 Dodge St, Kaukauna, Wisconsin |
| Authorized Official Name and Position | William J. Farrow (OWNER/PRESIDENT) |
| Authorized Official Contact | 9207669542 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaukauna Family Dentistry, S.c. 233 Dodge St Kaukauna WI 54130-2500 Ph: (920) 766-9542 | Kaukauna Family Dentistry, S.c. 233 Dodge St Kaukauna WI 54130-2500 Ph: (920) 766-9542 |
| NPI Number | 1073604013 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 06/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073604013 | NPI | - | NPPES |
| 38377600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5001987-015 (Wisconsin) | Primary |
Kaukauna Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 233 Dodge St, Kaukauna, WI 54130 Phone: 920-766-9542 | |
Krupka Dental Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1810 Crooks Ave, Suite 3, Kaukauna, WI 54130 Phone: 920-766-1122 |