East Towne Dental Associates Belgium Family Dental SC
Organization Active NPI Dentist · Belgium, WI
NPI 1164560165 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1164560165
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 5304 (WI)
- Legal business name
- EAST TOWNE DENTAL ASSOCIATES BELGIUM FAMILY DENTAL SC
- Practice address
- 171 Main St
Suite 200
Belgium, WI 53004 - Phone
- (262) 285-3408
- Fax
- (262) 285-4025
- NPI assigned
- Feb 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Vali Kiaie, DDS
- Title
- President
- Phone
- (262) 285-3408
Corporate family (same tax ID) 2
Practitioners 1
-
Vali Kiaie, DDS
National Provider Directory
- Tax ID family
- East Towne Dental Associated Belgium Family Dental SC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 5301 | WI | |
| Dentist |
122300000X | 5304 | WI | Yes |
| Dentist |
122300000X | 5993 | WI |
Addresses
Primary practice location
171 Main St
Suite 200
Belgium, WI 53004
Mailing address
PO Box 147
Belgium, WI 53004
Phone (262) 285-3408
Other providers in Belgium, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.