Wd Dental Implant
Clinic/Center, Dental in Plymouth, WI. Organization (NPI-2).
NPI number1487429205
StatusActive
Last updated in NPPESNov 21, 2023
Details
- NPI
- 1487429205
- Entity type
- Organization (NPI-2)
- Legal business name
- Wd Dental Implant
- Organization subpart
- No
- Enumeration date
- Nov 21, 2023
- Certification date
- Nov 21, 2023
- Last updated
- Nov 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- You Smile Dental Implant Center (Doing Business As)
Practice location
21 S Bruns AvePlymouth, WI 53073-2562
Phone 920-892-2951
Mailing address
21 S Bruns AvePlymouth, WI 53073-2562
Phone 920-892-2951
Authorized official
Denise Shih O'Brien
Owner
4145206806
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