| Lake Breeze Dental, Llc | |
|
3712 Kadow St Manitowoc WI 54220-5450 | |
| (920) 684-8033 | |
| Not Available |
| Full Name | Lake Breeze Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3712 Kadow St, Manitowoc, Wisconsin |
| Authorized Official Name and Position | Adam Pasono (DENTIST/OWNER) |
| Authorized Official Contact | 9206391215 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Breeze Dental, Llc 379 Clermont Ct De Pere WI 54115-4075 Ph: (920) 639-1215 | Lake Breeze Dental, Llc 3712 Kadow St Manitowoc WI 54220-5450 Ph: (920) 684-8033 |
| NPI Number | 1811871197 |
|---|---|
| Provider Enumeration Date | 08/01/2025 |
| Last Update Date | 08/01/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811871197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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