| Family Dental Center, Sc | |
|
3712 Kadow St Manitowoc WI 54220-5450 | |
| (920) 684-8033 | |
| (920) 684-6360 |
| Full Name | Family Dental Center, Sc |
|---|---|
| Speciality | Dentist |
| Location | 3712 Kadow St, Manitowoc, Wisconsin |
| Authorized Official Name and Position | Kathy Ellen Seidl (BUSINESS ASSISTANT) |
| Authorized Official Contact | 9206848033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dental Center, Sc 3712 Kadow St Manitowoc WI 54220-5450 Ph: (920) 684-8033 | Family Dental Center, Sc 3712 Kadow St Manitowoc WI 54220-5450 Ph: (920) 684-8033 |
| NPI Number | 1639246127 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639246127 | NPI | - | NPPES |
| 38393000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3890 (Wisconsin) | Primary |
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