| Sauk Trail Dental Llc | |
|
661 E Green Bay Ave Saukville WI 53080-2013 | |
| (262) 284-7111 | |
| Not Available |
| Full Name | Sauk Trail Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 661 E Green Bay Ave, Saukville, Wisconsin |
| Authorized Official Name and Position | Genevieve Poppe (PARTNER) |
| Authorized Official Contact | 6083583370 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sauk Trail Dental Llc 661 E Green Bay Ave Saukville WI 53080-2013 Ph: (262) 284-7111 | Sauk Trail Dental Llc 661 E Green Bay Ave Saukville WI 53080-2013 Ph: (262) 284-7111 |
| NPI Number | 1457697229 |
|---|---|
| Provider Enumeration Date | 12/21/2012 |
| Last Update Date | 06/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457697229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2485-15 (Wisconsin) | Secondary |
| 1223G0001X | Dentist - General Practice | 2334-15 (Wisconsin) | Primary |
Antisdel Dental Clinic, S.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 661 E Green Bay Ave, Saukville, WI 53080 Phone: 262-284-7111 Fax: 262-284-1172 |