| Medical Arts Complex Dental Center, S.c. | |
|
704 S Webster Ave Green Bay WI 54301-3528 | |
| (920) 435-6894 | |
| (920) 435-7676 |
| Full Name | Medical Arts Complex Dental Center, S.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 704 S Webster Ave, Green Bay, Wisconsin |
| Authorized Official Name and Position | Gary C. Noble (VICE-PRESIDENT) |
| Authorized Official Contact | 9204356894 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Arts Complex Dental Center, S.c. 704 S Webster Ave Green Bay WI 54301-3528 Ph: (920) 435-6894 | Medical Arts Complex Dental Center, S.c. 704 S Webster Ave Green Bay WI 54301-3528 Ph: (920) 435-6894 |
| NPI Number | 1376626325 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376626325 | NPI | - | NPPES |
| 33571900 | Medicaid | WI | |
| 33738400 | Medicaid | WI | |
| 33777700 | Medicaid | WI | |
| 33461900 | Medicaid | WI | |
| 33759300 | Medicaid | WI | |
| 33734500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4416 (Wisconsin) | Primary |
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