| Mark Brodhagen Dds Sc | |
|
1052 Bel Aire Court Green Bay WI 54304 | |
| (920) 499-2121 | |
| (920) 499-7644 |
| Full Name | Mark Brodhagen Dds Sc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1052 Bel Aire Court, Green Bay, Wisconsin |
| Authorized Official Name and Position | Mark Andrew Brodhagen (OWNER) |
| Authorized Official Contact | 9204992121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Brodhagen Dds Sc 1052 Bel Aire Court Green Bay WI 54304 Ph: (920) 499-2121 | Mark Brodhagen Dds Sc 1052 Bel Aire Court Green Bay WI 54304 Ph: (920) 499-2121 |
| NPI Number | 1164500591 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 11/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164500591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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