| East Towne Dental Associates Belgium Family Dental Sc | |
|
171 Main St Suite 200 Belgium WI 53004 | |
| (262) 285-3408 | |
| (262) 285-4025 |
| Full Name | East Towne Dental Associates Belgium Family Dental Sc |
|---|---|
| Speciality | Dentist |
| Location | 171 Main St, Belgium, Wisconsin |
| Authorized Official Name and Position | Vali Kiaie (PRESIDENT) |
| Authorized Official Contact | 2622853408 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Towne Dental Associates Belgium Family Dental Sc Po Box 147 Belgium WI 53004 Ph: (262) 285-3408 | East Towne Dental Associates Belgium Family Dental Sc 171 Main St Suite 200 Belgium WI 53004 Ph: (262) 285-3408 |
| NPI Number | 1164560165 |
|---|---|
| Provider Enumeration Date | 02/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164560165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5301 (Wisconsin) | Secondary |
| 122300000X | Dentist | 5304 (Wisconsin) | Primary |
| 122300000X | Dentist | 5993 (Wisconsin) | Secondary |
Belgium Family Dental Center Sc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 171 Main St Ste 200, Belgium, WI 53004 Phone: 262-285-3408 Fax: 262-285-4025 |