Mosinee Family Dental LLC
Dentist in Mosinee, WI. Organization (NPI-2).
NPI number1982143574
StatusActive
Last updated in NPPESFeb 16, 2017
Details
- NPI
- 1982143574
- Entity type
- Organization (NPI-2)
- Legal business name
- Mosinee Family Dental LLC
- Organization subpart
- No
- Enumeration date
- Feb 16, 2017
- Last updated
- Feb 16, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 5542-15 | WI | Yes |
| 122300000X | Dentist | 5001639-15 | WI |
Practice location
435 Orbiting Dr Ste AMosinee, WI 54455-1762
Phone 715-693-4530
Mailing address
435 Orbiting Dr Ste AMosinee, WI 54455-1762
Phone 715-693-4530
Authorized official
Leah Bouton
Office Manager
7156934530
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