| Fondy Family Dental | |
|
35 W Scott St Fond Du Lac WI 54935-2342 | |
| (920) 922-2930 | |
| Not Available |
| Full Name | Fondy Family Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 35 W Scott St, Fond Du Lac, Wisconsin |
| Authorized Official Name and Position | Chad Goeke (OWNER/DENTIST) |
| Authorized Official Contact | 8155419561 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fondy Family Dental 35 W Scott St Fond Du Lac WI 54935-2342 Ph: (920) 922-2930 | Fondy Family Dental 35 W Scott St Fond Du Lac WI 54935-2342 Ph: (920) 922-2930 |
| NPI Number | 1962099101 |
|---|---|
| Provider Enumeration Date | 12/22/2020 |
| Last Update Date | 12/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962099101 | NPI | - | NPPES |
| 1548619265 | Medicaid | WI | |
| 1285780171 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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