| Fond Du Lac Family Dentistry, Llc | |
|
145 S Marr St Ste 1 Fond Du Lac WI 54935-4419 | |
| (920) 922-9000 | |
| Not Available |
| Full Name | Fond Du Lac Family Dentistry, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 145 S Marr St Ste 1, Fond Du Lac, Wisconsin |
| Authorized Official Name and Position | Daniel Stevens (OWNER/DENTIST) |
| Authorized Official Contact | 9209229000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fond Du Lac Family Dentistry, Llc 145 S Marr St Ste 1 Fond Du Lac WI 54935-4419 Ph: (920) 922-9000 | Fond Du Lac Family Dentistry, Llc 145 S Marr St Ste 1 Fond Du Lac WI 54935-4419 Ph: (920) 922-9000 |
| NPI Number | 1982271763 |
|---|---|
| Provider Enumeration Date | 06/09/2021 |
| Last Update Date | 06/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982271763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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