| Mdc Bellevue, L.l.c. | |
|
2040 Central Ct Green Bay WI 54311-6276 | |
| (920) 468-0504 | |
| Not Available |
| Full Name | Mdc Bellevue, L.l.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2040 Central Ct, Green Bay, Wisconsin |
| Authorized Official Name and Position | William C Mauthe (OWNER) |
| Authorized Official Contact | 9209211244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mdc Bellevue, L.l.c. 7 Sheboygan St Fond Du Lac WI 54935-4281 Ph: (920) 922-8171 | Mdc Bellevue, L.l.c. 2040 Central Ct Green Bay WI 54311-6276 Ph: (920) 468-0504 |
| NPI Number | 1396105474 |
|---|---|
| Provider Enumeration Date | 03/02/2016 |
| Last Update Date | 03/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396105474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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