Timbercrest Dental Center, S.c. | |
821 E 1st Ave Suite 3 Appleton WI 54911-1501 | |
(920) 734-9148 | |
(920) 734-8710 |
Full Name | Timbercrest Dental Center, S.c. |
---|---|
Speciality | Clinic/center - Dental |
Location | 821 E 1st Ave, Appleton, Wisconsin |
Authorized Official Name and Position | John Berton Luther (PRESIDENT) |
Authorized Official Contact | 9207349148 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Timbercrest Dental Center, S.c. 821 E 1st Ave Suite 3 Appleton WI 54911-1501 Ph: (920) 734-9148 | Timbercrest Dental Center, S.c. 821 E 1st Ave Suite 3 Appleton WI 54911-1501 Ph: (920) 734-9148 |
NPI Number | 1356414114 |
---|---|
Provider Enumeration Date | 11/17/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356414114 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 5588-015 (Wisconsin) | Primary |
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