Sunridge Dental LLC
Dentist in Green Bay, WI. Organization (NPI-2).
NPI number1891172425
StatusActive
Last updated in NPPESMay 4, 2015
Details
- NPI
- 1891172425
- Entity type
- Organization (NPI-2)
- Legal business name
- Sunridge Dental LLC
- Organization subpart
- No
- Enumeration date
- May 4, 2015
- Last updated
- May 4, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 6367 | WI | Yes |
Other names
- Jill M Carter, DDS (Other Name)
Practice location
2926 Finger RdGreen Bay, WI 54311-7548
Phone 920-468-8085
Mailing address
2926 Finger RdGreen Bay, WI 54311-7548
Phone 920-468-8085
Authorized official
Jill M Carter
Owner
9204688085
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