| Paul D. Dibley, D.d.s., S.c. | |
|
920 E 5th St Shawano WI 54166-2212 | |
| (715) 526-3315 | |
| Not Available |
| Full Name | Paul D. Dibley, D.d.s., S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 920 E 5th St, Shawano, Wisconsin |
| Authorized Official Name and Position | Paul D. Dibley (PRESIDENT) |
| Authorized Official Contact | 7155263315 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul D. Dibley, D.d.s., S.c. 920 E 5th St Shawano WI 54166-2212 Ph: () - | Paul D. Dibley, D.d.s., S.c. 920 E 5th St Shawano WI 54166-2212 Ph: (715) 526-3315 |
| NPI Number | 1720078512 |
|---|---|
| Provider Enumeration Date | 10/24/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720078512 | NPI | - | NPPES |
| 33617100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5001351015 (Wisconsin) | Primary |
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