| Abc Family Dental Services, S.c. | |
|
613 Center Dr Luxemburg WI 54217-1031 | |
| (920) 845-2225 | |
| (920) 845-5627 |
| Full Name | Abc Family Dental Services, S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 613 Center Dr, Luxemburg, Wisconsin |
| Authorized Official Name and Position | Bryan William Iwen (PRESIDENT) |
| Authorized Official Contact | 9208452225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Abc Family Dental Services, S.c. 613 Center Dr Luxemburg WI 54217-1031 Ph: (920) 845-2225 | Abc Family Dental Services, S.c. 613 Center Dr Luxemburg WI 54217-1031 Ph: (920) 845-2225 |
| NPI Number | 1871638254 |
|---|---|
| Provider Enumeration Date | 02/21/2007 |
| Last Update Date | 04/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871638254 | NPI | - | NPPES |
| 33740400 | Medicaid | WI | |
| 33744300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4930 AND 4892 (Wisconsin) | Primary |