| Mt Calvary Dental Llc | |
|
100 Evergreen Rd Mount Calvary WI 53057-9726 | |
| (920) 753-2771 | |
| Not Available |
| Full Name | Mt Calvary Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 100 Evergreen Rd, Mount Calvary, Wisconsin |
| Authorized Official Name and Position | Caitlin Bloomer (OWNER/DENTIST) |
| Authorized Official Contact | 9206451219 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mt Calvary Dental Llc 3500 Woodview Ln Saukville WI 53080-1400 Ph: (920) 645-1219 | Mt Calvary Dental Llc 100 Evergreen Rd Mount Calvary WI 53057-9726 Ph: (920) 753-2771 |
| NPI Number | 1780288977 |
|---|---|
| Provider Enumeration Date | 11/28/2020 |
| Last Update Date | 11/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780288977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |