| Modern Dental Center Llc | |
|
101 Camelot Dr Ste 3 Fond Du Lac WI 54935-8048 | |
| (920) 921-1244 | |
| Not Available |
| Full Name | Modern Dental Center Llc |
|---|---|
| Speciality | Dentist |
| Location | 101 Camelot Dr Ste 3, Fond Du Lac, Wisconsin |
| Authorized Official Name and Position | Michael Cole (VP INSURANCE PLAN MANAGEMENT) |
| Authorized Official Contact | 7274242990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Dental Center Llc 101 Camelot Dr Ste 3 Fond Du Lac WI 54935-8048 Ph: (920) 921-1244 | Modern Dental Center Llc 101 Camelot Dr Ste 3 Fond Du Lac WI 54935-8048 Ph: (920) 921-1244 |
| NPI Number | 1689320897 |
|---|---|
| Provider Enumeration Date | 02/25/2022 |
| Last Update Date | 02/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689320897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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