| Univeristy Dental Llc | |
|
1833 University Ave Green Bay WI 54302-3637 | |
| (920) 437-7444 | |
| (920) 437-7862 |
| Full Name | Univeristy Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 1833 University Ave, Green Bay, Wisconsin |
| Authorized Official Name and Position | Daniel E Tache (OWNER) |
| Authorized Official Contact | 9204377444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Univeristy Dental Llc 1833 University Ave Green Bay WI 54302-3637 Ph: (920) 437-7444 | Univeristy Dental Llc 1833 University Ave Green Bay WI 54302-3637 Ph: (920) 437-7444 |
| NPI Number | 1538232202 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538232202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5089-015 (Massachusetts) | Primary |
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