MDC Omro, S.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MDC OMRO, S.C.

Doing business as

Dowling Dental Clinic of Omro

Practice address

1771 E Main St
Omro, WI 54963-1594

Phone

(920) 685-2121

NPI assigned

Mar 19, 2013

Last updated

Mar 19, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. William Mauthe III, D.D.S.

Title

Owner

Phone

(920) 948-6407

Specialties & licenses 1

Addresses

Other names 1

• Dowling Dental Clinic of Omro Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Dowling, DDS

  • General Practice Dentistry
  • Omro, WI
  • NPI 1649374273
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1285976167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CAMELOT DR",
            "address_2": "STE 3",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358048",
            "telephone_number": "920-579-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 E MAIN ST",
            "city": "OMRO",
            "state": "WI",
            "postal_code": "549631594",
            "telephone_number": "920-685-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDC OMRO, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "MAUTHE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-948-6407",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dowling Dental Clinic of Omro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alyson P Larson, MD
• Jennie Laue, COTA/L
• Thomas Robert Machak, D.D.S.
• Kelly L McCormick, OTR/L
• Rachel L McInnis, MS/CCC-SLP
• Chad Meyer, COTA
• Tina Morey, RN
• Sarah Lynn O'Connell, R.N.
• Jennifer Oaks, PTA
• Off-the-Track Counseling LLC

• General Practice Dentistry in Omro, WI
• Providers in Omro, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.