| Northern Door Dental Sc | |
|
10589 S Highland Rd Ste 4 Sister Bay WI 54234 | |
| (920) 854-5200 | |
| (920) 854-7601 |
| Full Name | Northern Door Dental Sc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10589 S Highland Rd Ste 4, Sister Bay, Wisconsin |
| Authorized Official Name and Position | Thomas Malcolm Mayhew (DENTIST PRACTICE PRESIDENT OWNER) |
| Authorized Official Contact | 9208545200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Door Dental Sc 10589 S Highland Rd Ste 4 Sister Bay WI 54234 Ph: (920) 854-5200 | Northern Door Dental Sc 10589 S Highland Rd Ste 4 Sister Bay WI 54234 Ph: (920) 854-5200 |
| NPI Number | 1013038207 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 07/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013038207 | NPI | - | NPPES |
| 33368800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5002020015 (Wisconsin) | Primary |
John E Ludwigsen Dds Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 940 South Bayshore Drive, Sister Bay, WI 54234 Phone: 920-854-6556 Fax: 920-854-6559 | |
Cliffside Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2645 S Bay Shore Dr, Sister Bay, WI 54234 Phone: 920-854-5200 |