| De Pere Smiles S.C. | |
|
277 N 9th St De Pere WI 54115-1548 | |
| (920) 336-6594 | |
| (920) 336-7132 |
| Full Name | De Pere Smiles S.C. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 277 N 9th St, De Pere, Wisconsin |
| Authorized Official Name and Position | Christopher James Peterson (PRESIDENT/OWNER/DENTIST) |
| Authorized Official Contact | 9203366594 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| De Pere Smiles S.C. 277 N 9th St De Pere WI 54115-1548 Ph: (920) 336-6594 | De Pere Smiles S.C. 277 N 9th St De Pere WI 54115-1548 Ph: (920) 336-6594 |
| NPI Number | 1225568983 |
|---|---|
| Provider Enumeration Date | 06/15/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225568983 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1001273-15 (Wisconsin) | Primary |
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