| North Shore Dental Group S.c. | |
|
2601 W Mequon Rd Mequon WI 53092-3151 | |
| (262) 242-1180 | |
| (262) 242-0930 |
| Full Name | North Shore Dental Group S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2601 W Mequon Rd, Mequon, Wisconsin |
| Authorized Official Name and Position | Allen D Langeberg (VICE PRESIDENT) |
| Authorized Official Contact | 2622421180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Shore Dental Group S.c. 11345 N Port Washington Rd Mequon WI 53092-3411 Ph: (262) 242-1180 | North Shore Dental Group S.c. 2601 W Mequon Rd Mequon WI 53092-3151 Ph: (262) 242-1180 |
| NPI Number | 1093868523 |
|---|---|
| Provider Enumeration Date | 01/19/2007 |
| Last Update Date | 11/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093868523 | NPI | - | NPPES |
| 816118 | Other | WI | UNITED CONCORDIA INSURANC |
| 38355900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2294 (Wisconsin) | Primary |
| 1223G0001X | Dentist - General Practice | 0776G (Wisconsin) | Secondary |
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› Verified 9 days ago
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