| Tri-county Community Dental Clinic, Inc. | |
|
9 Tri Park Way Appleton WI 54914-1661 | |
| (920) 882-9989 | |
| (920) 882-9961 |
| Full Name | Tri-county Community Dental Clinic, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9 Tri Park Way, Appleton, Wisconsin |
| Authorized Official Name and Position | Sandy Drexler (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9208829989 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-county Community Dental Clinic, Inc. 9 Tri Park Way Appleton WI 54914-1661 Ph: (920) 882-9989 | Tri-county Community Dental Clinic, Inc. 9 Tri Park Way Appleton WI 54914-1661 Ph: (920) 882-9989 |
| NPI Number | 1336237551 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 08/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336237551 | NPI | - | NPPES |
| 38392800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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