Midwest Dental Freeport | |
421 Market St Freeport PA 16229-1121 | |
(724) 295-5125 | |
(724) 295-5126 |
Full Name | Midwest Dental Freeport |
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Speciality | Dentist - General Practice |
Location | 421 Market St, Freeport, Pennsylvania |
Authorized Official Name and Position | Diane Marie Brion-martin (CREDENTIALING TEAM LEAD) |
Authorized Official Contact | 7155982311 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Midwest Dental Freeport 680 Hehli Way Mondovi WI 54755-1639 Ph: (715) 598-2311 | Midwest Dental Freeport 421 Market St Freeport PA 16229-1121 Ph: (724) 295-5125 |
NPI Number | 1740791524 |
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Provider Enumeration Date | 10/19/2017 |
Last Update Date | 10/19/2017 |
Identifier | Type | State | Issuer |
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1740791524 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 3139-15 (Wisconsin) | Primary |